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Individual

DR. CASEY A HOLTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
17100 W NORTH AVE, SUITE 100, BROOKFIELD, WI 53005-4436
(262) 786-9184
(262) 786-1906
Mailing address
17100 W NORTH AVE, SUITE 100, BROOKFIELD, WI 53005-4436
(414) 810-7647

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
594-226
WI
101YP2500X
Professional Counselor
4444-125
WI
103TC0700X
Clinical Psychologist
Primary
2962-57
WI

Other

Enumeration date
08/18/2010
Last updated
04/10/2013
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