MEDICARE: AJA HEALING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1427859248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJA HEALING

Provider Business Mailing Address
First Line	:	2656 N TEUTONIA AVE UNIT 6566
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-3421
Country	:	US
Telephone Number	:	262-229-9258
Fax Number	:

Provider Business Practice Location Address
First Line	:	7801 W MILL RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-1147
Country	:	US
Telephone Number	:	262-229-9258
Fax Number	:

Authorized Official
Title or Position	:	MANGER
Name	:	SHANICE BAUET
Credential	:	PHD
Telephone Number	:	262-229-9258

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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Directions to “AJA HEALING ” Practice Location

Language	Start Address	Practice Location

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