| NPI | 1750980306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA J FALKERS Owner/Clinic Director 608-501-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2024-07-03 |