Individual
MR. WALTER LEMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2821 N 4TH ST, SUITE 139, MILWAUKEE, WI 53212-2362
(414) 264-4217
(414) 264-4218
Mailing address
2821 N 4TH ST, SUITE 139, MILWAUKEE, WI 53212-2362
(414) 264-4217
(414) 264-4218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11343-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39173800
—
WI
Enumeration date
04/29/2008
Last updated
04/29/2008
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