Individual
MR. GROVER SCANLAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CAPSW
Contact information
Practice address
3801 N 88TH ST, MILWAUKEE, WI 53222-2706
(414) 793-2796
(262) 965-4107
Mailing address
PO BOX 158, DOUSMAN, WI 53118-0158
(414) 793-2796
(262) 965-4107
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100060402
—
WI
Enumeration date
06/11/2021
Last updated
06/11/2021
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