| NPI | 1285162016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON A HANSEN Behavioral Health Counselor 920-420-3188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2937-226) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: WI 34629) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2017-05-24 |