| NPI | 1790077741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RUSSO President 608-251-0839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 1384123) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |