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NPI Code Detail

MEDICARE: KELAH FOREST HATCHER MSW

MEDICARE: KELAH FOREST HATCHER MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker11933-123WI

General Provider Information

NPI Number : 1144044777
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELAH FOREST HATCHER MSW
Provider Business Mailing Address
First Line : 2450A N DOUSMAN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3040
Country : US
Telephone Number : 715-419-0956
Fax Number :
Provider Business Practice Location Address
First Line : 3365 S 103RD ST STE 100
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-4162
Country : US
Telephone Number : 414-321-3951
Fax Number : 414-321-8307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2024
Last Update Date : 11/12/2024

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Directions to “ KELAH FOREST HATCHER MSW” Practice Location

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