Healthcare Provider Details

I. General information

NPI: 1457751893
Provider Name (Legal Business Name): AMRI COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W CAPITOL DR
MILWAUKEE WI
53216-2530
US

IV. Provider business mailing address

4001 W CAPITOL DR
MILWAUKEE WI
53216-2530
US

V. Phone/Fax

Practice location:
  • Phone: 414-810-6691
  • Fax:
Mailing address:
  • Phone: 414-810-6691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. DANA MARIE SMITH
Title or Position: THERAPIST
Credential: SAC-IT
Phone: 414-795-6833