| NPI | 1689117202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHRISTINE FOSKETT Dr. Of Clinical Psychology 608-841-1442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 3076-57) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2021-03-09 |