Shaker, Brienne A

Shaker, Brienne A is an sole proprietor health care provider with primary practice located at 571 Braund St , Onalaska WI 54650. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shaker, Brienne A can be contacted via phone (608) 785-7000.

Contact Information

Primary practice address
571 Braund St Onalaska WI 54650
Fax: (608) 785-7477
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 9391-123 Wisconsin

Profile Details

NPI number 1255852653
LBN Legal business name Shaker, Brienne A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2017
Last updated Oct 19th, 2023 - about last year

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 1255852653 NPPES
Wisconsin MEDICAID 100068761

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