Individual
MR. KENNETH A SIECZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-III
Contact information
Practice address
12970 W BLUEMOUND RD, 308, ELM GROVE, WI 53122-2607
(262) 780-1020
(262) 780-1022
Mailing address
12970 W BLUEMOUND RD, 308, ELM GROVE, WI 53122-2607
(262) 780-1020
(262) 780-1022
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13092
WI
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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