Hubbert, Raven M

Hubbert, Raven M is an sole proprietor health care provider with primary practice located at 4741 N 72Nd St , Milwaukee WI 53218-4815. She recently has only one registered license in Behavioral Health & Social Service Providers / Health Service, which is considered as her primary health care specialty. Hubbert, Raven M can be contacted via phone (414) 982-8107.

Contact Information

Primary practice address
4741 N 72Nd St Milwaukee WI 53218-4815
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X

Profile Details

NPI number 1336810217
LBN Legal business name Hubbert, Raven M
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2021
Last updated Sep 21st, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336810217 NPPES
Wisconsin MEDICAID 83441842

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