Individual
MR. MICHAEL LEO CHAMPEAU
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2711 19TH ST, RACINE, WI 53403-2314
(262) 637-8888
(262) 637-0695
Mailing address
2711 19TH ST, RACINE, WI 53403-2314
(262) 637-8888
(262) 637-0695
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1106123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39550300
—
WI
Enumeration date
11/25/2005
Last updated
07/08/2007
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