| NPI | 1992406995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE MOORE Psychologist 608-609-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-03-15 |