Individual
MR. RAYMOND K SPADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC
Contact information
Practice address
2240 PRAIRIE AVE., BELOIT, WI 53511
(608) 361-7200
(608) 361-7201
Mailing address
2240 PRAIRIE AVE, BELOIT, WI 53511-2648
(608) 361-7200
(608) 361-7201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16737130
WI
Other
Enumeration date
06/11/2013
Last updated
12/30/2014
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