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Individual

MR. ROGER K ASIJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSINMFT, CSAC

Contact information

Practice address
6040 W LISBON AVE STE 200, MILWAUKEE, WI 53210-2116
(414) 447-9890
(414) 447-9891
Mailing address
4330 S 38TH ST, MILWAUKEE, WI 53221-2005
(414) 447-9890
(414) 447-9891

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14969-132
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43702100
WI
Enumeration date
03/05/2007
Last updated
07/09/2007
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