Individual
BRANDON MICHAEL OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1622 CHESTNUT ST, WEST BEND, WI 53095-3014
(262) 353-6127
Mailing address
1622 CHESTNUT ST, WEST BEND, WI 53095-3014
(262) 353-6127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20137-130
WI
101YM0800X
Mental Health Counselor
Primary
133047-121
WI
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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