| NPI | 1760992788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRIAN SMOTHERS Owner 414-367-9413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2973) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WI 303957) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |