Organization
1 STEP AWAY DIVINE COUNSELING SERVICE LLC
Active
Other names
1 STEP AWAY DIVINE
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN JEAN BOYD-REED B.S. SAC- IT (ADMINISTRATOR)
(414) 839-6457
Entity
Organization
Contact information
Practice address
6815 W CAPITOL DR STE 308, MILWAUKEE, WI 53216-2056
(414) 839-6457
(414) 446-9798
Mailing address
6506 W FLORAL LN, BROWN DEER, WI 53223-1230
(414) 839-6457
(414) 446-9798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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