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General NPI Number Information
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NPI Number | 1629964671
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Entity Type | Individual
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Provider Name | GEETA RAVAL MS
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1442 S 92ND ST
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City | WEST ALLIS
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State | WI
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Zip | 53214-4235
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Country | US
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Telephone | 414-897-9467
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Fax |
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Provider Business Mailing Address
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Address Line | 2119 N SUMMIT AVE APT 301
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City | MILWAUKEE
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State | WI
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Zip | 53202-1309
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Country | US
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Telephone | 917-345-6556
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8484226
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License Number State | WI
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