| NPI | 1962950865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GOURLEY Therapist 608-466-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8384-123) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2022-08-08 |