| NPI | 1790958106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M CORNALE Director 262-567-4560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1313) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |