Individual
MR. JONATHAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
2603 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2711
(414) 263-8352
Mailing address
PO BOX 1709, MILWAUKEE, WI 53201-1709
(262) 510-7953
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15567-130
WI
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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