| NPI | 1760593727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L ELGIN Director Of Business Operations 920-458-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 1499) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |