Individual
FRED A BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC, ICS
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
(414) 967-7020
Mailing address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
(414) 967-7020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11950-132
WI
Other
Enumeration date
07/22/2011
Last updated
04/30/2014
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