Individual
MELISSA CRUIKSHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
1212 S 70TH ST, SUITE 115-A, WEST ALLIS, WI 53214-3105
(414) 312-1394
Mailing address
1212 S 70TH ST, SUITE 115-A, WEST ALLIS, WI 53214-3105
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5244-125
WI
Other
Enumeration date
12/17/2013
Last updated
01/22/2014
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