NPI | 1972077527 |
---|---|
Doing Business As | LOTUS |
Entity Type | Organization |
Authorized Contact | KRYSTAL A CONKLE Owner/Therapist 608-618-5560 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2019-01-16 |
Last Update Date | 2023-10-16 |