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General NPI Number Information
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NPI Number | 1528413671
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Entity Type | Organization
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Legal Business Name | ADVENTURES IN PLAY, LLC
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 2118 E KENILWORTH PL LOWR
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City | MILWAUKEE
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State | WI
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Zip | 53202-1327
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Country | US
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Telephone | 847-722-6704
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Fax | 414-306-7171
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Provider Business Mailing Address
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Address Line | 2118 E KENILWORTH PL LOWR
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City | MILWAUKEE
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State | WI
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Zip | 53202-1327
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Country | US
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Telephone | 847-722-6704
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Fax | 414-306-7171
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Authorized Official
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Title or Position | THERAPIST
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Name | STEPHANIE L MILLER
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Credential | M.S., L.C.S.W.
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Telephone | 847-722-6704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 8463-123
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License Number State | WI
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