Healthcare Provider Details

I. General information

NPI: 1205543170
Provider Name (Legal Business Name): BRIANNA RAE BUEHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 S 108TH ST
HALES CORNERS WI
53130-1321
US

IV. Provider business mailing address

W276N9293 RED WING RD
HARTLAND WI
53029-9427
US

V. Phone/Fax

Practice location:
  • Phone: 414-296-1730
  • Fax:
Mailing address:
  • Phone: 262-719-5471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11465-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: