Individual
JORGE AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
4555 W SCHROEDER DR, BROWN DEER, WI 53223-1475
(414) 586-0222
(414) 586-0236
Mailing address
2101 S 60TH ST, WEST ALLIS, WI 53219-1569
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14669-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41160600
—
WI
Enumeration date
06/19/2008
Last updated
06/19/2008
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