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Individual

MR. CHRISTOPHER MICHAEL DAVID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
Mailing address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149012107
IL
1041C0700X
Clinical Social Worker
Primary
7355-123
WI

Other

Enumeration date
05/04/2009
Last updated
07/05/2011
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