Provider Demographics
NPI:1427840503
Name:AJA HEALING
Entity type:Organization
Organization Name:AJA HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. HOLISTIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAQUET
Authorized Official - Suffix:
Authorized Official - Credentials:DHM
Authorized Official - Phone:262-457-9815
Mailing Address - Street 1:8430 W CAPITOL DR STE 3025
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1846
Mailing Address - Country:US
Mailing Address - Phone:262-457-9815
Mailing Address - Fax:
Practice Address - Street 1:8430 W CAPITOL DR STE 3025
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1846
Practice Address - Country:US
Practice Address - Phone:262-457-9815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty