Individual
GERALD ALLAN THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.W.
Contact information
Practice address
6040 W LISBON AVE, MILWAUKEE, WI 53210-2116
(414) 871-9111
(414) 871-9121
Mailing address
6040 W LISBON AVE, MILWAUKEE, WI 53210-2116
(414) 871-9111
(414) 871-9121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
362-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39533800
—
WI
Enumeration date
07/26/2006
Last updated
07/08/2007
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