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Individual

JUDSON CHUBBUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
16535 W BLUEMOUND RD, SUITE 200, BROOKFIELD, WI 53005-5936
(262) 789-1191
(262) 821-6180
Mailing address
4928 W WISCONSIN AVE, MILWAUKEE, WI 53208-3052
(414) 774-1052

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3233125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40963300
WI
Enumeration date
12/19/2006
Last updated
02/05/2009
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