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Individual

MR. TIMOTHY JOHN SCHWALLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSSW

Contact information

Practice address
1126 S 70TH ST, WEST ALLIS, WI 53214-3151
(415) 727-7289
Mailing address
568 N 105TH ST, WAUWATOSA, WI 53226-4330
(414) 774-7135

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4131-123
WI
1041S0200X
School Social Worker
050912
WI

Other

Enumeration date
10/08/2008
Last updated
10/08/2008
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