JOSEPH WHITE EAGLE

BARABOO, WI
NPI1033531108
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16099-131)
Enumeration Date2014-01-09
Last Update Date2016-11-30
Business Address
-- JOSEPH WHITE EAGLE SAC
S2845 WHITE EAGLE RD
BARABOO, WI 53913-9064
Phone number: 608-355-1240
Mailing Address
-- JOSEPH WHITE EAGLE SAC
S2845 WHITE EAGLE RD
BARABOO, WI 53913-9064
Phone number: 608-355-1240
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