| NPI | 1609046788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE FAYE PORTIS-PATTERSON Clinical Director/Therapist 262-884-9734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 947-125) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2011-02-15 |