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Individual
SHANNON BROEKER
Active
Individual
SHANNON BROEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11969-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11969
COUNSELOR
WI
01
—
7529
STATE OF WISONSIN
WI
Enumeration date
06/19/2024
Last updated
01/13/2026
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