| NPI | 1639329113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JOHNSON Credentialing Manager 715-532-9771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 2632) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2008-09-22 |