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General NPI Number Information
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NPI Number | 1851132898
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Entity Type | Individual
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Provider Name | ALISHA M GATHING
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 11414 W PARK PL STE 202
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City | MILWAUKEE
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State | WI
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Zip | 53224-3500
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Country | US
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Telephone | 414-292-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 5032 N 26TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53209-5509
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Country | US
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Telephone | 414-331-3560
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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 |
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License Number State | WI
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