| NPI | 1588959571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA B COWAN Psychologist 715-848-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2859-057) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-27 |