Individual
JASMINE WEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5322 N DEXTER AVE, MILWAUKEE, WI 53209-5040
(414) 400-3199
Mailing address
5322 N DEXTER AVE, MILWAUKEE, WI 53209-5040
(414) 400-3199
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
WI
320800000X
Mental Illness Community Based Residential Treatment Facility
—
WI
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
WI
Other
Enumeration date
05/04/2022
Last updated
04/08/2026
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