Basic Information
| Provider Information | |||||||||
| NPI: | 1003156746 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRAUS | ||||||||
| FirstName: | ALISHA | ||||||||
| MiddleName: | R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1930 N PROSPECT AVE | ||||||||
| Address2: | APT 51 | ||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532021491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9209483194 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9501 W WATERTOWN PLANK RD | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532263552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4142573141 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2013 | ||||||||
| LastUpdateDate: | 02/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 128847-121 | WI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.