Most Relevant Information
Provider Data
| NPI Number: | 1003214685 |
| Provider Name: | SHANTREASE BENSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/12/2014 |
| Last Updated: | 12/12/2014 |
Provider Practice Location
2677 N 40TH ST
MILWAUKEE
WI
532102505
Practice Location Phone/Fax
| Phone: | 4144471965 |
| Fax: | 4148742820 |
Provider Mailing Location
2677 N 40TH ST
PO BOX 100268
MILWAUKEE
WI
532102505
Provider Mailing Phone/Fax
| Phone: | 4144471965 |
| Fax: | 4148742820 |