Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003054636 |
---|---|
Provider Name | Crystal Z Mclean |
First Address | Milwaukee, WI 53203-1802 |
Second Address | Milwaukee, WI 53203-1802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2009 |
Last Update Date | 04/02/2009 |