Individual
SEPHORA ABIGAIL WAWA EGBUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Mailing address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7302
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7302
LICENSE
WI
Enumeration date
03/25/2024
Last updated
03/25/2024
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