Individual
TROY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, SAC-IT
Contact information
Practice address
618 PRAIRIE AVE, SPARTA, WI 54656-2534
(608) 633-8065
Mailing address
618 PRAIRIE AVE, SPARTA, WI 54656-2534
(608) 633-8065
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16428-131
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
18480-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003150004
—
WI
Enumeration date
06/05/2018
Last updated
02/16/2021
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