| NPI | 1740440924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT L FENTON Sole Proprietor 608-628-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2531057) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-07-15 |