| NPI | 1861803512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY JORGENSON Owner 608-345-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 4026123) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4026126) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |