Provider Demographics
NPI:1659544765
Name:HADLEY, ANN J (MS)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:J
Last Name:HADLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5363 N 51ST BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3304
Mailing Address - Country:US
Mailing Address - Phone:414-365-8580
Mailing Address - Fax:
Practice Address - Street 1:5363 N 51ST BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-3304
Practice Address - Country:US
Practice Address - Phone:414-365-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40911900Medicaid