| NPI | 1386048551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY S TARVID Registered Agent/Mbr 414-491-0377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 7099-123) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |