| NPI | 1992154231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KAY DUGGAN Clinical Psychologist 414-801-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2783-57) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |