| NPI | 1841311123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN GARY LEVINE Psychologist 262-391-5780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 1073-057) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |