| NPI | 1508939372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY TYLER WATSON Psychologist Clinical Director 920-457-9192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2563-057) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |