Individual
BRADLEY RAY HAWBECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC 15654-131
Contact information
Practice address
2240 PRAIRE AVE, 10, BELOIT, WI 53511-2940
(608) 361-7200
(608) 361-7201
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15654-131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42247900
—
WI
Enumeration date
01/30/2008
Last updated
08/18/2011
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