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Individual
BARRY DEXTER
Active
Individual
BARRY DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2087
WI
104100000X
Social Worker
1583-120
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1583-120
STATE LICENSE
WI
01
—
2087-132
STATE LICENSE
WI
Enumeration date
08/11/2006
Last updated
04/15/2013
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