Individual
MR. KIM N CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC, ICS
Contact information
Practice address
612 N RANDALL AVE STE A, JANESVILLE, WI 53545-1958
(608) 752-7660
(608) 752-9788
Mailing address
1232 WILSHIRE PL, WAUKESHA, WI 53188-3311
(414) 416-4777
(262) 544-1321
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11905-134 & 1806-132
WI
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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