Organization
AUTISM SOCIETY OF SOUTHEASTERN WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WAGNER (OFFICE MANAGER)
(414) 988-1261
Entity
Organization
Contact information
Practice address
3720 N 124TH ST STE O, WAUWATOSA, WI 53222-2100
(414) 988-1260
Mailing address
3720 N 124TH ST STE O, WAUWATOSA, WI 53222-2100
(414) 988-1260
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
11/30/2023
Last updated
12/11/2023
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