| NPI | 1588315501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON YOUNG Psychotherapist/Co Owner 262-880-4039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-06-17 |