Individual
GREGORY STROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
1626 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 338-8611
Mailing address
1626 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 338-8611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16868-130
WI
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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