Individual
DR. MARICA SHAVA TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2125 DERRIN LN, BROOKFIELD, WI 53045-2151
(414) 297-7745
(262) 641-9768
Mailing address
2125 DERRIN LN, BROOKFIELD, WI 53045-2151
(414) 297-7745
(262) 641-9768
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4775-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43715200
—
WI
Enumeration date
06/16/2008
Last updated
10/18/2023
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