Individual
DAVID WALTER KINGSFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC CSIT
Contact information
Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Mailing address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16049-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100060438
—
WI
Enumeration date
12/17/2012
Last updated
09/12/2018
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