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NPI Code Detail

MEDICARE: MISS JENNY MARIE ROEMER SAC-IT

MEDICARE: MISS JENNY MARIE ROEMER SAC-IT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15866-130WI

General Provider Information

NPI Number : 1992036891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNY MARIE ROEMER SAC-IT
Provider Business Mailing Address
First Line : 3707 N RICHARDS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-1673
Country : US
Telephone Number : 414-967-7004
Fax Number : 414-967-7023
Provider Business Practice Location Address
First Line : 3707 N RICHARDS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-1673
Country : US
Telephone Number : 414-967-7004
Fax Number : 414-967-7023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2010
Last Update Date : 01/18/2010

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Directions to “ MISS JENNY MARIE ROEMER SAC-IT” Practice Location

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