Individual
ERIC ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
3301 N BALLARD RD, APPLETON, WI 54911-8928
(920) 733-4443
Mailing address
3301 N BALLARD RD, APPLETON, WI 54911-8928
(920) 733-4443
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20400-130
WI
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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