| NPI | 1417163882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LAWRENCE PALMER Owner, Psychotherapist 920-819-0865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WI 6948-123) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |