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 |