Provider Demographics
NPI:1831662535
Name:EHRGOOD, MARY (DMIN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:EHRGOOD
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S WHITAKER CT
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-9271
Mailing Address - Country:US
Mailing Address - Phone:262-366-4627
Mailing Address - Fax:
Practice Address - Street 1:AURORA FAMILY SERVICE
Practice Address - Street 2:3200 W HIGHLAND BLVD
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208
Practice Address - Country:US
Practice Address - Phone:414-342-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist