Healthcare Provider Details

I. General information

NPI: 1649902552
Provider Name (Legal Business Name): OLIVIA RAE RASHED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE STE 165
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

3711 S 93RD ST
MILWAUKEE WI
53228-1615
US

V. Phone/Fax

Practice location:
  • Phone: 414-337-3400
  • Fax: 414-337-3409
Mailing address:
  • Phone: 414-333-0730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10075-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: