| NPI | 1720353741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON GAE O'BRIEN Therapist 414-372-7212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7197-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 1971-132) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-07-05 |