| NPI | 1356794788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTAL STEPHANY Owner 920-251-4214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 6151-125) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2017-04-07 |