Individual
SEAN GERATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
809 PARK AVE, BEAVER DAM, WI 53916-2205
(920) 463-0118
Mailing address
809 PARK AVE, BEAVER DAM, WI 53916-2205
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18083
EMPLOYEE IDENTIFICATION
—
Enumeration date
01/23/2019
Last updated
01/23/2019
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