| NPI | 1437336583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARI C MARTIN Psychotherapist 920-469-8890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WI 1951-125) |
| Additional Taxonomies | 251S00000X (Licence: WI 13018-020) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-01-30 |