| NPI | 1487075214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY M WELK Owner 920-461-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2021-10-28 |