Individual
ALEXANDER WAITES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-IT
Contact information
Practice address
4811 S 76TH ST # 305, GREENFIELD, WI 53220-4364
(414) 325-7741
Mailing address
4811 S 76TH ST STE 305, GREENFIELD, WI 53220-4364
(414) 325-7741
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5032-226
WI
101YP2500X
Professional Counselor
Primary
10314-125
WI
Other
Enumeration date
07/26/2021
Last updated
03/16/2023
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