Individual
JAMES EDWARD PUCKETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
600 3RD ST N, LA CROSSE, WI 54601-6234
(608) 519-5547
Mailing address
600 3RD ST N, LA CROSSE, WI 54601-6234
(608) 519-5546
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16168-132
WI
101YP2500X
Professional Counselor
Primary
6550-125
WI
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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