| NPI | 1417359324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE R EDDY Owner/Psychotherapist 920-883-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 6671-123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1598) |
| 1041C0700X Social Worker, Clinical (Licence: WI 6671-123) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2017-12-04 |