| NPI | 1609412667 |
|---|---|
| Doing Business As | IMPACT, LLC |
| Entity Type | Organization |
| Authorized Contact | CHASIDY DAWN WILKE Owner / Clinic Director 715-966-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |