| NPI | 1639553100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL DOZER Behavioral Health Clinician 1 715-299-6949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 1407911795) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |