Individual
SAMMY JOE RANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
840 LAKE AVE, 101, RACINE, WI 53403-1566
(262) 634-8688
(262) 634-7547
Mailing address
840 LAKE AVE, 101, RACINE, WI 53403-1566
(262) 634-8688
(262) 634-7547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14088-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14088-132
STATE OF WISCONSIN DEPARTMENT OF REGULATION AND LICENSING
WI
Enumeration date
09/16/2008
Last updated
09/16/2008
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