Individual
JASON A WITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
4402 S 68TH ST, #100, GREENFIELD, WI 53220-3479
(414) 321-4411
(414) 321-0552
Mailing address
155 TENNY AVE, WAUKESHA, WI 53186-6450
(262) 501-2975
(414) 321-0552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40924900
—
WI
Enumeration date
11/06/2006
Last updated
07/08/2007
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