Individual
JOSHUA GROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
201 S GLENRIDGE CT, APPLETON, WI 54914-3905
(920) 279-9268
Mailing address
201 S GLENRIDGE CT, APPLETON, WI 54914-3905
(920) 279-9268
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16251-132
WI
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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