Individual
PAMELA HAUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6232 BANKERS RD LOWR LEVEL, MOUNT PLEASANT, WI 53403-9747
(262) 583-0137
(262) 583-0097
Mailing address
730 SHERIDAN RD APT 203, KENOSHA, WI 53140-1181
(262) 914-0507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12150
WI
1041C0700X
Clinical Social Worker
Primary
7187-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11013500
—
WI
Enumeration date
03/26/2007
Last updated
12/18/2024
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