Individual
JAMES KINTA SUMMERALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2655 N FRATNEY ST, MILWAUKEE, WI 53212-2950
(414) 791-4996
Mailing address
2655 N FRATNEY ST, MILWAUKEE, WI 53212-2950
(414) 791-4996
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YM0800
WI
101YM0800X
Mental Health Counselor
Primary
1381-26202844
WI
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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