| 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 | 2025-08-05 |