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Organization
SACRED WANDERING / SACRED PATH PRACTITIONERS
Active
Organization
SACRED WANDERING / SACRED PATH PRACTITIONERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH J NELAN MS, LPC, NCC (OWNER/PROVIDER)
(414) 433-9193
Entity
Organization
Contact information
Practice address
10134 N PORT WASHINGTON RD STE G, MEQUON, WI 53092-5700
(414) 433-9193
(414) 435-9611
Mailing address
10134 N PORT WASHINGTON RD STE G, MEQUON, WI 53092-5700
(414) 433-9193
(414) 435-9611
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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