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General NPI Number Information
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NPI Number | 1548250376
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Entity Type | Individual
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Provider Name | NEAL ETHAN MOGLOWSKY M.S., L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 250 N SUNNY SLOPE RD SUITE 128
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City | BROOKFIELD
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State | WI
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Zip | 53005-4809
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Country | US
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Telephone | 262-782-2820
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Fax | 262-782-6937
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Provider Business Mailing Address
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Address Line | 8205 N 38TH ST
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City | BROWN DEER
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State | WI
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Zip | 53209-1513
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Country | US
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Telephone | 414-362-0327
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Fax | 262-782-6937
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2836-125
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License Number State | WI
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