Individual
MARY BETH SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 W WELLS ST, MILWAUKEE, WI 53203-1830
(414) 272-0123
Mailing address
4600 N. CRAMER STREET, MILWAUKEE, WI 53211
(414) 332-5431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2561-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558405795
CLINIC NUMBER
WI
Enumeration date
02/22/2007
Last updated
07/08/2007
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