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General NPI Number Information
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NPI Number | 1932690997
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Entity Type | Individual
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Provider Name | MARK ANDREW MILAEGER
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Gender | Male
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1220 DEWEY AVE # 11
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City | WAUWATOSA
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State | WI
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Zip | 53213-2504
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Country | US
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Telephone | 833-528-7672
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Fax |
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Provider Business Mailing Address
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Address Line | 525 S 65TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53214-1725
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Country | US
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Telephone | 262-617-6899
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 18591-130
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11221-125
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License Number State | WI
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