Provider Demographics
NPI:1174812705
Name:VERHALEN, BOJANA (BS, MA, LPC)
Entity type:Individual
Prefix:MS
First Name:BOJANA
Middle Name:
Last Name:VERHALEN
Suffix:
Gender:F
Credentials:BS, MA, LPC
Other - Prefix:
Other - First Name:BOJANA
Other - Middle Name:
Other - Last Name:PUSKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4800 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2412
Mailing Address - Country:US
Mailing Address - Phone:414-744-5370
Mailing Address - Fax:414-744-9052
Practice Address - Street 1:4800 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-2412
Practice Address - Country:US
Practice Address - Phone:414-744-5370
Practice Address - Fax:414-744-9052
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5232-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor