| NPI | 1295130276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA F. HARRY Provider 920-410-7364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1809-123) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2023-08-28 |