| NPI | 1336989938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE SHERIDAN Mental Health Professional 262-865-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-05-30 |