| NPI | 1932625357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY NEVINS Administrative Director 715-381-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 1436-057) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2018-05-08 |