is a Clinical in Wauwatosa, Wisconsin. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1174635213. The last update date is .
's current location address is 10400 W North Ave, Wauwatosa, Wisconsin. You can contact this provider via phone number 4147773178 and fax number 4147773204. The mailing address for is 10400 W North Ave, Wauwatosa, Wisconsin. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 10400 W North Ave, Wauwatosa, Wisconsin |
Phone Number | 4147773178 |
Fax Number | 4147773204 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1174635213 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 10400 W North Ave |
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City | Wauwatosa |
State | Wisconsin (WI) |
Post Code | 532262425 |
Phone Number | 4147773178 |
Fax Number | 4147773204 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | 1421 |
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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41005100 | WI | -- |
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