Individual
RUSSELL JOHN DENOMIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
Mailing address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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