| NPI | 1942933163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA M SUPINGER Licensed Psychologist 414-745-9325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2024-08-23 |