Individual
MARY HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT, PC-IT
Contact information
Practice address
6416 S HOWELL AVE, OAK CREEK, WI 53154-1104
(414) 762-5429
(414) 762-9727
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16067-130
WI
101YP2500X
Professional Counselor
Primary
1054-226
WI
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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