| NPI | 1730691205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FANNIN Owner/Counselor 608-385-7559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5465-125) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2017-10-24 |