Burgoyne, Rene Ann
Burgoyne, Rene Ann is an individual health care provider with primary practice located at 12970 W Bluemound Rd Suite 308, Elm Grove WI 53122-2607. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Burgoyne, Rene Ann can be contacted via phone (262) 780-1020.Contact Information
Primary practice address
12970 W Bluemound Rd Suite 308
Elm Grove WI 53122-2607
Phone: (262) 780-1020
Fax: (262) 780-1022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Art Therapist | 221700000X | 66-036 | Wisconsin |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3853-125 | Wisconsin |
Profile Details
| NPI number | 1952493470 |
|---|---|
| LBN Legal business name | Burgoyne, Rene Ann |
| Credentials | MS, ATRL-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Sep 18th, 2008 - about 16 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 | 1952493470 | NPPES |
| Wisconsin | Other | 66-036 | ART THERAPIST |
| Wisconsin | MEDICAID | 40967900 | ART THERAPIST |
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