Individual
JEAN MORAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10012 W CAPITOL DR STE 101, MILWAUKEE, WI 53222-1300
(414) 810-4844
Mailing address
10012 W CAPITOL DR STE 101, MILWAUKEE, WI 53222-1300
(414) 810-4844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
568004
WI
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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