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Individual

BIANCA RENEE WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4738 W LISBON AVE, MILWAUKEE, WI 53208-1127
(414) 687-5731
Mailing address
4160 N 39TH ST, MILWAUKEE, WI 53216-1664
(414) 687-5731

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W4520769164807
STATE IDENTIFICATION
WI
Enumeration date
02/14/2020
Last updated
02/14/2020
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