| NPI | 1275961021 |
|---|---|
| Doing Business As | CHW PAIN AND HEADACHE CLINIC |
| Entity Type | Organization |
| Authorized Contact | WELDON GAGE Treasurer/Chief Financial Officer 414-266-6401 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 3186-57) |
| 106H00000X Marriage & Family Therapist (Licence: WI 662-124) | |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2014-09-25 |