Individual
STEPHANIE A. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LPC-IT
Contact information
Practice address
3636 N 124TH ST, WAUWATOSA, WI 53222-2125
(414) 476-9755
(414) 476-3413
Mailing address
3636 N 124TH ST, WAUWATOSA, WI 53222-2125
(414) 476-9755
(414) 476-3413
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1796-226
WI
103K00000X
Behavior Analyst
Primary
88-140
WI
Other
Enumeration date
11/17/2010
Last updated
02/04/2015
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