| Transformationservices | |
|
835 N 23rd St 212 Milwaukee WI 53233-3300 | |
| (414) 933-7083 | |
| (414) 933-7883 |
| Full Name | Transformationservices |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 835 N 23rd St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Ingrid Diann Hicks (CLINICAL & EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4149337083 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformationservices 835 N 23rd St 212 Milwaukee WI 53233-3300 Ph: (414) 933-7083 | Transformationservices 835 N 23rd St 212 Milwaukee WI 53233-3300 Ph: (414) 933-7083 |
| NPI Number | 1558593129 |
|---|---|
| Provider Enumeration Date | 08/17/2009 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558593129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15226-130 (Wisconsin) | Primary |
| 103TC0700X | Psychologist - Clinical | 1198 (Wisconsin) | Secondary |
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