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General NPI Number Information
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NPI Number | 1245048495
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Entity Type | Individual
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Provider Name | VENESIA Y NEELY COUNSELOR
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1433 N WATER ST FL 4
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City | MILWAUKEE
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State | WI
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Zip | 53202-2557
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | 4911 W WELLS ST APT 2E
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City | MILWAUKEE
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State | WI
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Zip | 53208-3085
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Country | US
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Telephone | 414-544-9091
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8662068469
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License Number State | WI
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