Individual
ZACHARY ETHAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3505 N 124TH ST, BROOKFIELD, WI 53005-2489
(414) 431-4444
Mailing address
3505 N 124TH ST, BROOKFIELD, WI 53005-2489
(850) 803-9126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8133-226
WI
Other
Enumeration date
09/21/2024
Last updated
09/21/2024
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