| NPI | 1396491403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LARSON Office Administration 262-223-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |