| Toni Liddy Llc | |
|
800 E Locust St Milwaukee WI 53212-2634 | |
| (414) 429-6522 | |
| (414) 502-0192 |
| Full Name | Toni Liddy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 800 E Locust St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Antonette Marie Liddy (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4144296522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Toni Liddy Llc 2369 S 57th St West Allis WI 53219-2215 Ph: (414) 429-6522 | Toni Liddy Llc 800 E Locust St Milwaukee WI 53212-2634 Ph: (414) 429-6522 |
| NPI Number | 1518358506 |
|---|---|
| Provider Enumeration Date | 02/11/2015 |
| Last Update Date | 02/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518358506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 244-125 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 244-125 (Wisconsin) | Primary |
| 104100000X | Social Worker | 244-125 (Wisconsin) | Secondary |
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