Provider Demographics
NPI:1356563159
Name:BANKIER, SHIRLEY MAE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:MAE
Last Name:BANKIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 N SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-3850
Mailing Address - Country:US
Mailing Address - Phone:414-332-2322
Mailing Address - Fax:414-963-8643
Practice Address - Street 1:930 E KNAPP ST
Practice Address - Street 2:STE. # 27
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2896
Practice Address - Country:US
Practice Address - Phone:414-276-2242
Practice Address - Fax:414-963-8643
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1496-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44287Medicare ID - Type Unspecified