Individual
MS. PRATIBHA SRIVASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7635 W OKLAHOMA AVE, SUITE 201, MILWAUKEE, WI 53219-3600
(414) 301-2445
Mailing address
15875 BROOK LN, BROOKFIELD, WI 53005-1460
(262) 527-1359
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8460-123
WI
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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