Healthcare Provider Details

I. General information

NPI: 1669166567
Provider Name (Legal Business Name): ALONA MCMURTRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W WELLS ST
MILWAUKEE WI
53233-2720
US

IV. Provider business mailing address

2020 W WELLS ST
MILWAUKEE WI
53233-2720
US

V. Phone/Fax

Practice location:
  • Phone: 414-476-9675
  • Fax: 414-755-1834
Mailing address:
  • Phone: 414-476-9675
  • Fax: 414-755-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12715-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: