| NPI | 1558119834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHAN YEN HONG-LISHNER Owner/Licensed Clinical Psychologis 920-915-0696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |