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1225201817
SANDRA M VANDOMELEN
HALES CORNERS, WI
NPI
1225201817
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 15463-130)
Enumeration Date
2008-04-04
Last Update Date
2008-04-04
Business Address
-- SANDRA M VANDOMELEN SAC-IT
9415 W FOREST HOME AVE SUITE #1
HALES CORNERS, WI 53130-1680
Phone number: 414-427-4884
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Mailing Address
-- SANDRA M VANDOMELEN SAC-IT
4555 W SCHROEDER DR SUITE 170
MILWAUKEE, WI 53223-1475
Phone number: 414-365-3210
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