Individual
JERRY MORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
1303 CHATHAM ST, RACINE, WI 53402-4947
(262) 598-1392
(262) 598-1395
Mailing address
1303 CHATHAM ST, RACINE, WI 53402-4947
(262) 589-1392
(262) 598-1395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17429-130
WI
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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