| NPI | 1578029443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATEY DIANE COLLINS Owner, Provider 262-749-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |