MEDICARE: BONNIE J BEHEE-SEMLER PHD SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2070-059	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1497733372	OTHER	WI	INDIVIDUAL NPI NUMBER

General Provider Information

NPI Number	:	1568668390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONNIE J BEHEE-SEMLER PHD SC

Provider Business Mailing Address
First Line	:	9505 N PHEASANT LN
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-1125
Country	:	US
Telephone Number	:	414-840-2551
Fax Number	:	414-540-0492

Provider Business Practice Location Address
First Line	:	6791 N GREEN BAY AVE
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53209-3422
Country	:	US
Telephone Number	:	414-840-2551
Fax Number	:	414-540-0492

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BONNIE JEAN BEHEE-SEMLER
Credential	:	PHD
Telephone Number	:	414-840-2551

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/21/2007

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