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Individual

MIRANDA MAY BEHNKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LBSW

Contact information

Practice address
1409 CLEVELAND AVE, MARINETTE, WI 54143-3918
(715) 735-0095
(715) 735-0094
Mailing address
715 PYLE DR, KINGSFORD, MI 49802-4456
(906) 774-0522
(906) 774-1570

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18736-130
WI
104100000X
Social Worker
9668-120
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
982471046475
PREFERRED ONE
01
MB085458
BCBS OF MI
MI
Enumeration date
07/12/2006
Last updated
11/20/2019
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