| NPI | 1346446259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELO TRINIDAD-CARRILLO Psychologist 608-270-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2648) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2008-06-18 |