Individual
MS. MEGAN E. ILSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2807-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104004076
—
WI
Enumeration date
02/04/2008
Last updated
02/07/2013
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