Individual
JEREMY AVNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
16535 W BLUEMOUND RD, BROOKFIELD, WI 53005-5936
(262) 999-3495
Mailing address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
(414) 477-9517
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9119-123
WI
1041C0700X
Clinical Social Worker
Primary
9119-123
WI
Other
Enumeration date
01/12/2021
Last updated
09/11/2024
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