| NPI | 1790032316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZIE HARRIS Psychologist 414-455-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4377-125) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |