| NPI | 1952665044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLU A KALLIES Marriage And Family Therapist 920-230-2207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 803-124) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |