Individual
KENNETH WOODLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
6001 W CENTER ST STE 201, MILWAUKEE, WI 53210-2154
(414) 324-5318
(414) 449-4850
Mailing address
6001 W CENTER ST STE 201, MILWAUKEE, WI 53210-2154
(414) 324-5318
(414) 449-4850
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15807
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447490073
—
WI
Enumeration date
08/21/2009
Last updated
08/21/2009
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