Organization
OLIVE BRANCH THERAPY AND FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA C HAYNES LPC (LICENSED PROFESSIONAL COUNSELOR)
(414) 429-8603
Entity
Organization
Contact information
Practice address
4369 S HOWELL AVE STE 305, MILWAUKEE, WI 53207-5055
(414) 465-8317
(141) 443-3445
Mailing address
3625 N 58TH BLVD, MILWAUKEE, WI 53216-2848
(414) 429-8603
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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