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1265642714
SANDRA J. MALONE
KENOSHA, WI
NPI
1265642714
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WI 10893-132)
Enumeration Date
2007-05-23
Last Update Date
2008-06-30
Business Address
SANDRA J. MALONE CSAC
2108 63RD ST
KENOSHA, WI 53143-4454
Phone number: 262-652-2406
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Mailing Address
SANDRA J. MALONE CSAC
6233 39TH AVE
KENOSHA, WI 53142-7015
Phone number: 262-654-1004
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