| NPI | 1609992098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE THOMAS KOSKI Owner 414-321-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1279) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 1279) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |