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Individual
MR. CHARLES D LIPFORD
Active
Individual
MR. CHARLES D LIPFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15413-131
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
302375
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003079708
—
WI
Enumeration date
07/03/2008
Last updated
06/30/2009
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