| NPI | 1477629640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA C ORTIZ Clinical Director Psychotherapist 262-782-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2564) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2564) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |