| NPI | 1467874990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE K. (MICKEY) CROTHERS Member 715-830-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-02-18 |