| Inner Awakenings Diagnostic And Counseling Clinic | |
|
436 Oakton Ave Pewaukee WI 53072-3542 | |
| (262) 691-2581 | |
| (262) 691-2761 |
| Full Name | Inner Awakenings Diagnostic And Counseling Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 436 Oakton Ave, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Melissa A Ford (OWNER) |
| Authorized Official Contact | 2626912581 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Awakenings Diagnostic And Counseling Clinic 436 Oakton Ave Pewaukee WI 53072-3542 Ph: (262) 691-2581 | Inner Awakenings Diagnostic And Counseling Clinic 436 Oakton Ave Pewaukee WI 53072-3542 Ph: (262) 691-2581 |
| NPI Number | 1679788103 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 02/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679788103 | NPI | - | NPPES |
| 42226000 | Medicaid | WI |
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