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Individual

MR. ALFONZO WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSE, LPC

Contact information

Practice address
1230 E AUER AVE SUITE 211, THE WAKE UP PROGRAM LLC, MILWAUKEE, WI 53212-2257
(414) 372-4483
(414) 372-4483
Mailing address
1230 E AUER AVE SUITE 211, THE WAKE UP PROGRAM LLC, MILWAUKEE, WI 53212-2257
(414) 372-4483
(414) 372-4483

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 3748-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43594100
WI
Enumeration date
11/02/2010
Last updated
11/02/2010
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