| NPI | 1316439292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KAYE WITTENBURG License Professional Counselor 920-509-1856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 6701-125) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-16 |