| NPI | 1376970657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA GISSIBL Psychologist 262-313-8339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WI 299757) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2016-08-25 |