| NPI | 1831480094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HANSON Owner 262-488-0603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 1540-123) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2011-04-22 |