Growth Support Services, Llc | |
11803 W North Ave Ste 206 Wauwatosa WI 53226-2077 | |
(414) 293-3966 | |
Not Available |
Full Name | Growth Support Services, Llc |
---|---|
Speciality | Counselor - Professional |
Location | 11803 W North Ave Ste 206, Wauwatosa, Wisconsin |
Authorized Official Name and Position | Erionia Dixon (OWNER) |
Authorized Official Contact | 4142933966 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Growth Support Services, Llc 11803 W North Ave Ste 206 Wauwatosa WI 53226-2077 Ph: (414) 293-3966 | Growth Support Services, Llc 11803 W North Ave Ste 206 Wauwatosa WI 53226-2077 Ph: (414) 293-3966 |
NPI Number | 1700621679 |
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Provider Enumeration Date | 07/01/2024 |
Last Update Date | 07/01/2024 |
Certification Date | 07/01/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700621679 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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