| NPI | 1922584515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY LUND Clinical Social Worker/Counselor 262-370-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2774-123) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |