Individual
PATRICK M CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 232-2332
Mailing address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
WI
Enumeration date
06/12/2017
Last updated
06/12/2017
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