| NPI | 1982064366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH E PORTER Owner 608-841-1606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 3198-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 3198-57) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2018-06-21 |