| NPI | 1740794627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY BAIRD CHAPIN Owner 608-302-9752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3043-57) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8396) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |