Individual
MS. TRENACE MARY UTTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 871-6122
(414) 871-2552
Mailing address
503 S 71ST ST, MILWAUKEE, WI 53214-1636
(414) 456-0708
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13278-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13278-130
SUBSTANCE ABUSE COUNSELOR
WI
Enumeration date
06/14/2007
Last updated
07/08/2007
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