Wi Cbt Center Llc | |
5215 N Ironwood Rd Suite 202 Pmb 1013 Glendale WI 53217 | |
(414) 367-4447 | |
Not Available |
Full Name | Wi Cbt Center Llc |
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Speciality | Social Worker - Clinical |
Location | 5215 N Ironwood Rd, Glendale, Wisconsin |
Authorized Official Name and Position | Edwin Bacalso (THERAPIST) |
Authorized Official Contact | 4143674447 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wi Cbt Center Llc 5215 N Ironwood Rd Suite 202 Pmb 1013 Glendale WI 53217 Ph: () - | Wi Cbt Center Llc 5215 N Ironwood Rd Suite 202 Pmb 1013 Glendale WI 53217 Ph: (414) 367-4447 |
NPI Number | 1164275004 |
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Provider Enumeration Date | 04/10/2024 |
Last Update Date | 05/07/2024 |
Certification Date | 05/07/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164275004 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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