| NPI | 1750747325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLIE K BABCOCK Lcsw 262-564-5305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 7968-123) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2019-05-14 |