Healthcare Provider Details

I. General information

NPI: 1356495923
Provider Name (Legal Business Name): LINDSEY MICHELLE MEJCHAR MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10702 W BURLEIGH ST
WAUWATOSA WI
53222-3310
US

IV. Provider business mailing address

10702 W BURLEIGH ST
WAUWATOSA WI
53222-3310
US

V. Phone/Fax

Practice location:
  • Phone: 414-777-0740
  • Fax: 414-777-0749
Mailing address:
  • Phone: 414-777-0740
  • Fax: 414-777-0749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: