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Individual

JORDAN CHARBONEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
561 N 15TH ST, MARQUETTE UNIVERSITY 7CS COMMUNITY COUNSELING CLINICS, MILWAUKEE, WI 53233-2237
(414) 288-5889
Mailing address
561 N 15TH ST, RM 150, MILWAUKEE, WI 53233-2237
(414) 288-4556

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
12/28/2007
Last updated
01/06/2010
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