Provider Demographics
NPI:1639484900
Name:BENT, DEBORAH A (MS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:A
Last Name:BENT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W WELLS ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-1866
Mailing Address - Country:US
Mailing Address - Phone:414-290-0449
Mailing Address - Fax:414-226-0351
Practice Address - Street 1:230 W WELLS ST
Practice Address - Street 2:SUITE 500
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-1866
Practice Address - Country:US
Practice Address - Phone:414-290-0449
Practice Address - Fax:414-226-0351
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15372132101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor