Individual
MR. MICHAEL P SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
548 N LAKE AVE, PHILLIPS, WI 54555-1028
(715) 339-6453
(715) 339-6450
Mailing address
548 N LAKE AVE, PHILLIPS, WI 54555-1028
(715) 339-6453
(715) 339-6450
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
246132
WI
Other
Enumeration date
01/25/2011
Last updated
01/26/2011
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