| NPI | 1356630040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ANNE O'DONNELL Owner 608-347-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 4013-125) |
| Enumeration Date | 2011-04-03 |
| Last Update Date | 2011-04-03 |