Bennett, Tracy Ann
Bennett, Tracy Ann is an individual health care provider with primary practice located at 4855 S Moorland Rd , New Berlin WI 53151-7494. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bennett, Tracy Ann can be contacted via phone (414) 266-3339.Contact Information
Primary practice address
4855 S Moorland Rd
New Berlin WI 53151-7494
Phone: (414) 266-3339
Fax: (414) 425-9803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 131056-121 | Wisconsin |
Profile Details
| NPI number | 1417629668 |
|---|---|
| LBN Legal business name | Bennett, Tracy Ann |
| Credentials | APSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2021 |
| Last updated | Mar 29th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417629668 | NPPES |
| Wisconsin | MEDICAID | 1417629668 |
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