Individual
JENNIFER L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSAC, ICS, CSW
Contact information
Practice address
1314 W NATIONAL AVE, MILWAUKEE, WI 53204-2114
(414) 727-7985
(414) 727-8121
Mailing address
1314 W NATIONAL AVE, MILWAUKEE, WI 53204-2114
(414) 727-7985
(414) 727-8121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39179200
—
WI
Enumeration date
10/18/2007
Last updated
02/11/2009
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