Andree Davis

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Brown Deer, WI

NPI 1780980342 · NPPES record last updated Jan 31, 2011

Key facts

NPI
1780980342
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
5600 W Brown Deer Rd
Suite 110
Brown Deer, WI 53223
Phone
(414) 810-6691
Fax
(866) 719-3024
NPI assigned
Jan 31, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

5600 W Brown Deer Rd
Suite 110
Brown Deer, WI 53223

Mailing address

5600 W Brown Deer Rd
Suite 110
Brown Deer, WI 53223

Other providers in Brown Deer, WI

All providers in Brown Deer, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.