| NPI | 1952808701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LANG Licensed Psychotherapist 414-702-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 221700000X Art Therapist (Licence: WI 51-036) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 51-036) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |