Provider Demographics
NPI:1568668390
Name:BONNIE J BEHEE-SEMLER PHD SC
Entity Type:Organization
Organization Name:BONNIE J BEHEE-SEMLER PHD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BEHEE-SEMLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-840-2551
Mailing Address - Street 1:9505 N PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1125
Mailing Address - Country:US
Mailing Address - Phone:414-840-2551
Mailing Address - Fax:414-540-0492
Practice Address - Street 1:6791 N GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3422
Practice Address - Country:US
Practice Address - Phone:414-840-2551
Practice Address - Fax:414-540-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2070-059103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39147400Medicaid
WI1497733372OtherINDIVIDUAL NPI NUMBER