Healthcare Provider Details

I. General information

NPI: 1578009080
Provider Name (Legal Business Name): ANNETTE L VEASEY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 W CAPITOL DR STE 308
MILWAUKEE WI
53216
US

IV. Provider business mailing address

4222 W CAPITOL DR STE 308
MILWAUKEE WI
53216-2500
US

V. Phone/Fax

Practice location:
  • Phone: 414-231-9996
  • Fax: 414-249-3312
Mailing address:
  • Phone: 262-343-5609
  • Fax: 414-249-3312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: