Individual
MR. SHAWN DULDREA RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 N DR MARTIN LUTHER KING DR STE 42, MILWAUKEE, WI 53212-3675
(414) 231-9956
Mailing address
3820 N 76TH ST APT 4, MILWAUKEE, WI 53222-3058
(414) 210-9956
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19727-130
WI
Other
Enumeration date
12/16/2024
Last updated
12/18/2024
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