| NPI | 1275907701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M ELLINGSWORTH Owner 920-784-9727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 2126-226) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2016-05-31 |