Individual
ERIC THORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 888-8051
Mailing address
6155 S 42ND ST, GREENFIELD, WI 53221-4525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20130-130
WI
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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