| NPI | 1700479730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PITTMAN Licensed Psychologist 414-208-7369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-02-20 |
| Last Update Date | 2021-02-20 |