| Ad Astra Therapy Llc | |
|
12425 Knoll Rd Ste 110 Elm Grove WI 53122-2656 | |
| (414) 502-7900 | |
| Not Available |
| Full Name | Ad Astra Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 12425 Knoll Rd Ste 110, Elm Grove, Wisconsin |
| Authorized Official Name and Position | Jordan Olsen (SOLE OWNER) |
| Authorized Official Contact | 9136693987 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ad Astra Therapy Llc 12425 Knoll Rd Ste 110 Elm Grove WI 53122-2656 Ph: (414) 502-7900 | Ad Astra Therapy Llc 12425 Knoll Rd Ste 110 Elm Grove WI 53122-2656 Ph: (414) 502-7900 |
| NPI Number | 1407684319 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407684319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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