Individual
MRS. BONNEKA TIFFANY SEALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, NCC,LPC,CSAC
Contact information
Practice address
3235 N 124TH ST, BROOKFIELD, WI 53005
(262) 290-3315
Mailing address
804 MINAKA DR, WAUKESHA, WI 53188-5604
(414) 828-8311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16190-132
WI
101YM0800X
Mental Health Counselor
Primary
6744-125
WI
101YP2500X
Professional Counselor
6744-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057092
—
WI
Enumeration date
05/31/2016
Last updated
06/02/2022
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