| NPI | 1851003826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH PAUL NEILITZ Clinical Therapist 920-521-8940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2023-05-27 |