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 |