Individual
TANZANIQUE CAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1337 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2712
(414) 672-6220
Mailing address
4570 S 27TH ST, MILWAUKEE, WI 53221-2145
(414) 672-1353
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18626-130
WI
101YP2500X
Professional Counselor
Primary
7552-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184105611
—
WI
Enumeration date
08/23/2018
Last updated
10/25/2019
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