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Individual

KAYLA FAZZARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1432 W FOREST HOME AVE # 400, MILWAUKEE, WI 53204-3228
(414) 567-5400
(414) 567-5359
Mailing address
1432 W FOREST HOME AVE STE 400, MILWAUKEE, WI 53204-3228
(414) 567-5400
(414) 567-5359

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18558-130
WI
101YP2500X
Professional Counselor
Primary
7720-125
WI

Other

Enumeration date
07/08/2020
Last updated
06/21/2023
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