| 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 |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5215 N Ironwood Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Edwin Bacalso (THERAPIST) |
| Authorized Official Contact | 2629955244 |
| 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 |
|---|---|
| Provider Enumeration Date | 04/10/2024 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164275004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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