| NPI | 1578382198 |
|---|---|
| Doing Business As | OPAL WATERS PSYCHOTHERAPY |
| Entity Type | Organization |
| Authorized Contact | GRACE KANZENBACH Owner 608-668-4035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-10-09 |