| NPI | 1811358948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL CARTER Mental Health Counselor 920-202-4427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 0178791) |
| Additional Taxonomies | 251S00000X (Licence: NM 0176681) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |