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Individual
MR. KENT THOMAS KOLLATH
Active
Individual
MR. KENT THOMAS KOLLATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC, CSIT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15399-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15401-133
WI
Other
Enumeration date
04/30/2008
Last updated
06/01/2012
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