Individual
JASON ALEXANDER LANNOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
8530 GREENWAY BLVD UNIT 204, MIDDLETON, WI 53562-4604
(410) 402-0562
Mailing address
8530 GREENWAY BLVD UNIT 204, MIDDLETON, WI 53562-4604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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