| NPI | 1457644007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA M RIVERA Psychotherapist 414-645-9345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 7618-123) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2011-05-16 |