Individual
ELLIS E MISCAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3505 N 124TH ST, BROOKFIELD, WI 53005-2489
(414) 431-4444
Mailing address
3505 N 124TH ST, BROOKFIELD, WI 53005-2489
(414) 431-4444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9089-226
WI
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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