Individual
LISA MARIE EIMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT, SAC-IT
Contact information
Practice address
10012 W CAPITOL DR, WAUWATOSA, WI 53222-1338
(414) 810-4844
(414) 810-4845
Mailing address
10012 W CAPITOL DR, WAUWATOSA, WI 53222-1338
(414) 810-4844
(414) 810-4845
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16857130
WI
101YM0800X
Mental Health Counselor
Primary
1566226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1566226
—
WI
05
—
16857130
—
WI
Enumeration date
04/01/2013
Last updated
12/08/2014
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