NPI | 1306614987 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC SOUCY RUEFF Owner/CEO/Physician 920-714-1753 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2023-12-13 |
Last Update Date | 2023-12-13 |