| NPI | 1619325164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN BONGERS Licensed Professional Counselor 920-750-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 5970-125) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |