| NPI | 1649821638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LUCZAK Office Manager 414-800-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2021-12-21 |