| Organization Name: | BARABOO PSYCHOLOGICAL SERVICES, INC |
| NPI Number: | 1174749725 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH JEAN MARTIN (THERAPIST) |
| Mailing Address: | 227 5th Ave Baraboo |
| State: | WI US |
| Postal Code: | 539132116 |
| Phone Number: | 6083569066 |
| Fax Number: | 6083569470 |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 396-44-800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |