Amanda Sara Gollhardt | Milwaukee, WI • PECOS Search

Amanda Sara Gollhardt

Social Worker

Behavioral Health & Social Service Providers

5000 W National Ave, Milwaukee, WI 53295-0001

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Sara Gollhardt does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1174806475
Provider Type
Individual
Full Name
Gollhardt, Amanda Sara
Title
Miss
Credential
MSW APSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/22/2011
Last Updated
9/22/2011

Contact Information

Practice Location

5000 W National Ave, Milwaukee, WI 53295-0001

Unlisted Fax

Mailing Location

5000 W National Ave, Milwaukee, WI 53295-0001

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 128423121 Wisconsin