| NPI | 1750314159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J DONNER Clinical Psychologist 262-657-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2142057) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2012-12-12 |