Individual
MS. VENA P BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
740 N WISCONSIN AVE, EKLHORN, WI 53121
(262) 723-7056
(262) 723-4692
Mailing address
W3020 WEAVER RD, ELKHORN, WI 53121
(262) 723-8082
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3431125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43592000
—
WI
Enumeration date
01/17/2007
Last updated
07/08/2007
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