Individual
SARA CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 75TH ST, KENOSHA, WI 53143-1544
(262) 909-6008
Mailing address
1400 75TH ST, KENOSHA, WI 53143-1544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16570-131
WI
104100000X
Social Worker
Primary
134112-121
WI
Other
Enumeration date
01/16/2023
Last updated
01/20/2023
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