| NPI | 1578317830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY BROOKE RALEY Lpc & CEO 608-609-4766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |