Organization
WISCONSIN MENTAL HEALTH ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ROBERT PROBST PSY.D. (PRESIDENT)
(920) 382-0071
Entity
Organization
Contact information
Practice address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(920) 382-0071
(262) 247-0654
Mailing address
744 RIDGE VIEW DR, HARTFORD, WI 53027-2808
(192) 038-2007
(262) 234-7065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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