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Individual

ANDRE JEROME MCDONALD I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.HT.

Contact information

Practice address
484 CLAYTON AVE, STEVENS POINT, WI 54481-2026
(715) 560-5325
Mailing address
484 CLAYTON AVE, STEVENS POINT, WI 54481-2026
(715) 560-5325

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
01/08/2021
Last updated
01/08/2021
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