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General NPI Number Information
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NPI Number | 1194405282
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Entity Type | Individual
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Provider Name | KATHLEEN E MAEDKE-HALL APSW
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 1661 N WATER ST STE 509
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City | MILWAUKEE
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State | WI
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Zip | 53202-2086
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Country | US
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Telephone | 414-943-0356
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Fax |
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Provider Business Mailing Address
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Address Line | 3064 S KINNICKINNIC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-2966
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Country | US
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Telephone | 414-943-0356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 134184-121
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License Number State | WI
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