| NPI | 1487383808 |
|---|---|
| Former Legal Business Name | K12 PSYCHOEDUCATIONAL SERVICES, LLC |
| Entity Type | Organization |
| Authorized Contact | TONYA KLEM Owner/Founder 715-256-7166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103TS0200X Psychologist School |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2023-12-19 |