| NPI | 1578688057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MARTIN President 262-515-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6568-123) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |