| NPI | 1407349657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI JOE DELISLE Executive Director 920-382-0445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 6745-125) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-11-05 |