| Doctor Name: | MS. BETH ANN WANKE |
| NPI Number: | 1225350903 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW, CSAC |
| License Number: | 15712-132 |
| Business Practice Address: | 3900 W Brown Deer Rd Brown Deer, WI - 53209 |
| Business Phone Number: | 4145402170 |
| Business Fax Number: | 4145402171 |
| Mailing Address: | 3900 W Brown Deer Rd, BROWN DEER |
| State: | WI |
| Postal Code: | 532091220 |
| Phone Number: | 4145402170 |
| Fax Number: | 4145402171 |
| NPI Enumeration Date: | 02/22/2010 |
| NPI Last Update Date: | 11/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15712-132 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |