Individual
MR. ANDREWS KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NO. 16927 - 130
Contact information
Practice address
5735 DURAND AVE, SUITE A, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Mailing address
5735 DURAND AVE, SUITE A, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16927-130
WI
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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