Individual
MS. BRENDA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4261 N TEUTONIA AVE, MILWAUKEE, WI 53209-6754
(414) 334-3063
Mailing address
4261 N TEUTONIA AVE, MILWAUKEE, WI 53209-6754
(414) 334-3063
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11284
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11284
LICENSE
WI
Enumeration date
11/25/2008
Last updated
11/25/2008
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