| NPI | 1275765513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE HALL Psychologist 920-882-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2719-057) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |