| NPI | 1275791485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEO WALLNER Owner 414-442-1751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 3935-125) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2011-11-10 |