Individual
JESSE ROBERT DASO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, SAC
Contact information
Practice address
1615 W ZEDLER LN, MEQUON, WI 53092-5426
(262) 365-3681
Mailing address
1615 W ZEDLER LN, MEQUON, WI 53092-5426
(262) 365-3681
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16240-131
WI
101YP2500X
Professional Counselor
Primary
6926-125
WI
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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