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Individual

ALEXANDER N ANNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ED.S, M.ED

Contact information

Practice address
405 E FOREST ST, OCONOMOWOC, WI 53066-3707
(262) 468-8990
Mailing address
1391 FOREST VIEW LN, OCONOMOWOC, WI 53066-3493
(262) 468-8990

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701006974
VA
101YM0800X
Mental Health Counselor
8283
NC
101YM0800X
Mental Health Counselor
Primary
8460
WI

Other

Enumeration date
03/10/2011
Last updated
04/12/2022
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