Individual
JAN GAINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9301 WASHINGTON AVE, RACINE, WI 53406-3752
(262) 687-8611
Mailing address
9301 WASHINGTON AVE, RACINE, WI 53406-3752
(262) 687-8611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11265
WI
101YP2500X
Professional Counselor
Primary
546
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11013500
—
WI
Enumeration date
03/20/2007
Last updated
09/11/2025
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