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9505 W Brown Deer Rd Milwaukee WI 53224-2011 | |
| (262) 345-5560 | |
| (262) 345-5531 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 9505 W Brown Deer Rd, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Linda Marie Rangel (INSURANCE COORADINATOR) |
| Authorized Official Contact | 2623455533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
W175n11120 Stonewood Dr Germantown WI 53022-6511 Ph: (262) 345-5560 | 9505 W Brown Deer Rd Milwaukee WI 53224-2011 Ph: (262) 345-5560 |
| NPI Number | 1386077816 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 08/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386077816 | NPI | - | NPPES |
| 42223600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4123-125 (Wisconsin) | Primary |
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