| NPI | 1992315592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCINE C DIXON Consultant/Clinical Coordinator 262-751-7507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |