Individual
CONNIE WORDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4383 N 27TH ST, MILWAUKEE, WI 53216-1809
(414) 871-8883
(414) 871-8950
Mailing address
N2817 STATE ROAD 57, NEW HOLSTEIN, WI 53061-9528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14458
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39165900
—
WI
Enumeration date
02/22/2007
Last updated
07/09/2007
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