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Individual

IESHA V SANDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
7720 W GOOD HOPE RD, MILWAUKEE, WI 53223-4516
(414) 536-0236
(414) 536-0260
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6077-125
WI
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1962923276
WI
Enumeration date
06/28/2017
Last updated
03/23/2022
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