| NPI | 1932434420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L. EASTIN Co Owner/Partner 608-271-9986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 1780-123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1477) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |