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NPI Code Detail

MEDICARE: SARAH CATHERINE MORAL

MEDICARE: SARAH CATHERINE MORAL
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
1101YM0800XMental Health Counselor132023WI

General Provider Information

NPI Number : 1619646197
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH CATHERINE MORAL
Provider Business Mailing Address
First Line : 2457 N WEIL ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3045
Country : US
Telephone Number : 414-315-8892
Fax Number :
Provider Business Practice Location Address
First Line : 2600 N MAYFAIR RD STE 400
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-1306
Country : US
Telephone Number : 414-939-9390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 09/08/2021

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Directions to “ SARAH CATHERINE MORAL ” Practice Location

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