| NPI | 1609644087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVITAL Y DESKALO Licensed Psychologist 414-324-8283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2024-03-04 |