Individual
JACQUELINE VENESIA MCRAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ICS, SAC-IT
Contact information
Practice address
4810 NORTHWESTERN AVE, MOUNT PLEASANT, WI 53406-1504
(262) 637-9984
(262) 637-9995
Mailing address
4810 NORTHWESTERN AVE, MOUNT PLEASANT, WI 53406-1504
(262) 637-9984
(262) 637-9995
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18414-130
WI
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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