Provider Demographics
NPI:1427859248
Name:AJA HEALING
Entity type:Organization
Organization Name:AJA HEALING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUET
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-229-9258
Mailing Address - Street 1:2656 N TEUTONIA AVE UNIT 6566
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-3421
Mailing Address - Country:US
Mailing Address - Phone:262-229-9258
Mailing Address - Fax:
Practice Address - Street 1:7801 W MILL RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-1147
Practice Address - Country:US
Practice Address - Phone:262-229-9258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty