Individual
ANNA JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 N MAYFAIR RD STE 650, WAUWATOSA, WI 53226-1322
(414) 771-9304
(414) 771-9543
Mailing address
3155 N 87TH ST, MILWAUKEE, WI 53222-3730
(920) 810-4281
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
WI
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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