Provider Demographics
NPI:1891088688
Name:MULLER, ANN HELENE (CAPSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:HELENE
Last Name:MULLER
Suffix:
Gender:F
Credentials:CAPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-3228
Mailing Address - Country:US
Mailing Address - Phone:262-930-1113
Mailing Address - Fax:
Practice Address - Street 1:5303 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-1021
Practice Address - Country:US
Practice Address - Phone:414-445-0997
Practice Address - Fax:414-448-0989
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128111-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker