Organization
WADE KOSKI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE KOSKI LCSW (MEMBER)
(414) 467-2477
Entity
Organization
Contact information
Practice address
4402 S 68TH ST, SUITE #100, GREENFIELD, WI 53220-3479
(414) 467-2477
(414) 321-0552
Mailing address
4402 S 68TH ST, SUITE #100, GREENFIELD, WI 53220-3479
(414) 467-2477
(414) 321-0552
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40959600
—
WI
Enumeration date
09/15/2014
Last updated
09/15/2014
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