| NPI | 1992570626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVORAH H VINEBURG Office Manager 920-246-4193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2023-11-22 |