Organization
STRESS MANAGEMENT & MENTAL HEALTH CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. CRAIG A. MODELL PH.D. (DIRECTOR/CO-OWNER)
(414) 962-9156
Entity
Organization
Contact information
Practice address
5225 N IRONWOOD RD, #102, GLENDALE, WI 53217-4909
(414) 962-9156
(414) 962-4356
Mailing address
10201 W LINCOLN AVE, #308, WEST ALLIS, WI 53227-2136
(414) 329-7000
(414) 329-7010
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7439-123
WI
Other
Enumeration date
03/20/2009
Last updated
03/20/2009
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