| NPI | 1992858179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA A GOSSENS Psychotherapist 920-882-6610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 802 123) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |