Individual
HINHPALOM A PHOUYBANHDYT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
3015 N 114TH ST, WAUWATOSA, WI 53222-4208
(414) 431-4444
(414) 431-0858
Mailing address
3015 N 114TH ST, WAUWATOSA, WI 53222-4208
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
43721700
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43721700
—
WI
Enumeration date
04/03/2008
Last updated
04/03/2008
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