| NPI | 1417988973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA LEE KOZLOWSKI President 414-871-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1066) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 1066) |
| 103TC1900X Psychologist, Counseling (Licence: WI 1066) | |
| 103T00000X Psychologist (Licence: WI 1066) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 1066) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-08-22 |