NPI | 1699164483 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA SIMS NGOLA Licensed Clinical Social Worker 608-239-5071 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6967-123) |
Enumeration Date | 2015-01-15 |
Last Update Date | 2015-01-15 |