Individual
MRS. TANYA L GERHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12690 W NORTH AVE, BROOKFIELD, WI 53005-4636
(262) 785-1008
(262) 785-0644
Mailing address
12690 W NORTH AVE, BROOKFIELD, WI 53005-4636
(262) 785-1008
(262) 785-0644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7278-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40915900
—
WI
Enumeration date
08/01/2006
Last updated
07/08/2007
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