Individual
TONY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
3948 N. 18TH STREET, MILWAUKEE, WI 53206
(414) 488-9512
Mailing address
3948 N 18TH ST, MILWAUKEE, WI 53206-2430
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18230
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18230
—
WI
Enumeration date
06/29/2017
Last updated
06/29/2017
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