| NPI | 1649311655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRIN JENSEN Office Manager 715-735-9536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6159) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 35255-020) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 32903) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 35255-020) | |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2020-08-22 |