Individual
KENNETH D FASBENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC, SCIT
Contact information
Practice address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378
Mailing address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13112-132
WI
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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