Doctor Name: | LIZA JAYNE DRAKE |
NPI Number: | 1023035474 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 7220123 |
Business Practice Address: | W4051 County Road Nn Elkhorn, WI - 531214338 |
Business Phone Number: | 2627413200 |
Business Fax Number: | 2627413315 |
Mailing Address: | 7432 W Bluemound Rd, WAUWATOSA |
State: | WI |
Postal Code: | 532133655 |
Phone Number: | 4148073477 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2006 |
NPI Last Update Date: | 03/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7220123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |