Individual
MR. KENNETH GINLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2573 N 52ND ST, MILWAUKEE, WI 53210-2730
(414) 236-0083
Mailing address
2573 N 52ND ST, MILWAUKEE, WI 53210-2730
(414) 236-0083
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15698-132
WI
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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