Individual
EUNICE BOATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3536 52ND ST, KENOSHA, WI 53144-2662
(262) 842-0538
Mailing address
3536 52ND ST, KENOSHA, WI 53144-2662
(262) 842-0538
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
131699
WI
1041C0700X
Clinical Social Worker
Primary
12096-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175176
—
WI
01
—
12096
LCSW LICENSE
WI
01
—
131699
APSW LICENSE
WI
Enumeration date
08/28/2020
Last updated
05/29/2025
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