| NPI | 1679725352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LEE CORNELLA- CARLSON Psychiatrist 414-727-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2605) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-16 |