| NPI | 1780258004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MILLER CEO 920-857-9041 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |