Individual
MR. JASON STUART KANTROWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
10042 N. BROOKDALE DR., MEQUON, WI 53092-5702
(414) 534-2979
(262) 292-8184
Mailing address
10042 N. BROOKDALE DR., MEQUON, WI 53092-5702
(414) 534-2979
(262) 292-8184
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4412-125
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/27/2010
Last updated
11/27/2010
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