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Individual

KEVIN G TERNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
600 W VIRGINIA ST, ATLAS STE 203, MILWAUKEE, WI 53204-1500
(414) 831-4500
Mailing address
1414 W WALKER ST, MILWAUKEE, WI 53204-2123

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15965-130
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15965-130
WI

Other

Enumeration date
11/22/2010
Last updated
12/03/2010
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