| NPI | 1992000657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J MOLLER Owner 715-386-0856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2320-057) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: WI 2320-057) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WI 2320-057) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3404) | |
| 103TC0700X Psychologist, Clinical (Licence: WI 2320-057) | |
| 103TC0700X Psychologist, Clinical (Licence: MN LP3404) | |
| 103TC1900X Psychologist, Counseling (Licence: WI 2320-057) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 2320-057) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP3404) | |
| 103TF0000X Psychologist, Family (Licence: WI 2320-057) | |
| 103TF0200X Psychologist, Forensic (Licence: WI 2320-057) | |
| 103T00000X Psychologist (Licence: MN LP3404) | |
| 103TF0200X Psychologist, Forensic (Licence: MN LP3404) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: WI 2320-057) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: MN LP3404) | |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2011-01-11 |