MEDICARE: MRS. AMELIA WESTBROOK

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	104100000X	Social Worker		WI

General Provider Information

NPI Number	:	1912662255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMELIA WESTBROOK

Provider Business Mailing Address
First Line	:	3872 N 8TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-3303
Country	:	US
Telephone Number	:	262-234-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	3872 N 8TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-3303
Country	:	US
Telephone Number	:	262-234-2688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	11/02/2021

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Directions to “ MRS. AMELIA WESTBROOK ” Practice Location

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