Individual
STEPHANY RAU BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CISW
Contact information
Practice address
3734 7TH AVE, SUITE 12, KENOSHA, WI 53140-5525
(262) 654-9370
(262) 654-9379
Mailing address
10011 136TH AVE, KENOSHA, WI 53142-7946
(262) 857-9697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
866-122
WI
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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