Doctor Name: | ANGELA BYERS |
NPI Number: | 1003245283 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1737-226 |
Business Practice Address: | 2300 N Mayfair Rd Ste 425 Wauwatosa, WI - 532261505 |
Business Phone Number: | 4147274455 |
Business Fax Number: | |
Mailing Address: | 2123 Sunnyside Dr, WAUKESHA |
State: | WI |
Postal Code: | 531862834 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 11/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1737-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |