Individual
JEANINE MARIE SHORTREED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
4325 S 60TH ST, #3, GREENFIELD, WI 53220-3508
(414) 546-0467
(414) 546-0678
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
Primary
15432-131
WI
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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