Provider Demographics
NPI:1982933479
Name:BRASKI, STEPHANIE I (MS SAC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:I
Last Name:BRASKI
Suffix:
Gender:F
Credentials:MS SAC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:I
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, RADCI
Mailing Address - Street 1:1531 S. ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915
Mailing Address - Country:US
Mailing Address - Phone:920-730-4411
Mailing Address - Fax:920-831-8439
Practice Address - Street 1:1531 S. ONEIDA ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915
Practice Address - Country:US
Practice Address - Phone:920-730-4411
Practice Address - Fax:920-831-8439
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15542-131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)