Individual
MRS. JACQUELINE SILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
1610 MILLER PARK WAY, WEST MILWAUKEE, WI 53214-3604
(414) 672-3801
(414) 672-6026
Mailing address
1610 MILLER PARK WAY, WEST MILWAUKEE, WI 53214-3604
(414) 672-3801
(414) 672-6026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16689-130
WI
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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