| NPI | 1477894244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED MARIE SPANN Therapist 262-960-1548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 7919-123) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |