| NPI | 1427088749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WAYNE MARTIN Director/Owner 715-365-6696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 4249-123) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |