Individual
MR. GARY L CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3267 S 16TH ST, OHIO BUILDING - ROOM 209, MILWAUKEE, WI 53215-4500
(414) 389-3111
(414) 389-3110
Mailing address
3267 S 16TH ST, OHIO BUILDING - ROOM 209, MILWAUKEE, WI 53215-4500
(414) 389-3111
(414) 389-3110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1762-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39621700
—
WI
Enumeration date
06/12/2006
Last updated
04/18/2008
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