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Individual

BRIAN J. WIMMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
6644 MONTGOMERY DR, GREENDALE, WI 53129-1331
(414) 840-1955
Mailing address
6644 MONTGOMERY DR, GREENDALE, WI 53129-1331
(414) 840-1955

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7925-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1041C0700X
WI
Enumeration date
09/28/2012
Last updated
09/28/2012
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