Individual
QUILLAN B GARRETT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CSW CSAC ICS
Contact information
Practice address
2319 W CAPITOL DR, MILWAUKEE, WI 53206-1919
(414) 442-7720
(414) 442-2167
Mailing address
2319 W CAPITOL DR, MILWAUKEE, WI 53206-1919
(414) 442-7720
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11522
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39383900
—
WI
Enumeration date
04/09/2008
Last updated
04/09/2008
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