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Individual

JAMES E KILGORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSAC, ICS

Contact information

Practice address
300 FEMRITE DR, MONONA, WI 53716-3716
(608) 222-7311
Mailing address
5900 MONONA DR STE 300, MONONA, WI 53716-3561
(608) 222-7311

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
11864-134
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1664-132
WI

Other

Enumeration date
04/06/2018
Last updated
04/06/2018
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