Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 16884-130 | |
Y | 102L00000X | Psychologist | 377457 | WI |
Y | 103T00000X | Psychologist | 377457 | WI |
NPI | 1013353770 |
---|---|
Provider Name | Afnan Musaitif |
First Address | Milwaukee, WI 53295-0001 |
Second Address | Milwaukee, WI 53295-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2013 |
Last Update Date | 15/04/2020 |