Individual
THOMAS SPEAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LCSW, CADC III
Contact information
Practice address
2314 N GRANDVIEW BLVD, SUITES 301 AND 110, WAUKESHA, WI 53188-1675
(262) 524-9416
(262) 524-9434
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1908-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39184300
—
WI
Enumeration date
07/26/2006
Last updated
11/30/2007
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