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1174128904
DONAVON KRUEGER
RACINE, WI
NPI
1174128904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-12-01
Last Update Date
2020-12-01
Business Address
DONAVON KRUEGER CTRS
1320 WISCONSIN AVE
RACINE, WI 53403-1978
Phone number: 262-687-2132
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Mailing Address
DONAVON KRUEGER CTRS
1320 WISCONSIN AVE
RACINE, WI 53403-1978
Phone number: 262-687-2132
Copy
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