| NPI | 1386070134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRIE E BOECKMAN Clinic Therapist 262-652-2406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 8047-123) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |