Organization
GROWTH SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIONIA DIXON LPC (OWNER)
(414) 293-3966
Entity
Organization
Contact information
Practice address
11803 W NORTH AVE STE 206, WAUWATOSA, WI 53226-2077
(414) 293-3966
Mailing address
11803 W NORTH AVE STE 206, WAUWATOSA, WI 53226-2077
(414) 293-3966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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