University of Wisconsin - La Crosse

NPI #1386368041 in La Crosse, Wisconsin

Provider Information

NPI Number: 1386368041
Entity Type: Organization
Organization Name: University of Wisconsin - La Crosse
Subpart: Yes (part of a larger organization)
Parent Organization: UNIVERSITY OF WISCONSIN - LA CROSSE
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Sep 27, 2022
Last Updated: Sep 27, 2022

Practice Location

Address: 1725 STATE ST
Address 2: 2106 CENTENNIAL HALL
City: La Crosse
State: Wisconsin
ZIP Code: 54601-5460
Phone: (608) 785-8073

Authorized Official

Name: CRYSTAL DAWN CHAMPION, PHD, LP
Title: DIRECTOR
Phone: (608) 785-8073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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