| NPI | 1295116325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA LYNN YOUNG Owner 920-450-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 8291-123) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |