Individual
MICHAEL OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
1622 CHESTNUT ST, WEST BEND, WI 53095-3014
(262) 338-9498
(262) 338-9506
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15918-130
WI
101YP2500X
Professional Counselor
Primary
4842
WI
Other
Enumeration date
12/24/2009
Last updated
10/02/2018
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