| NPI | 1366065351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA M. MAUK CEO/Owner 715-575-1421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2023-01-10 |