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1336299817
RICHARD R. DETTLAFF
WAUKESHA, WI
NPI
1336299817
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 1355)
Enumeration Date
2007-01-10
Last Update Date
2013-12-10
Business Address
Mr. RICHARD R. DETTLAFF bs,csac
514 RIVERVIEW AVE
WAUKESHA, WI 53188-3631
Phone number: 262-548-7666
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Mailing Address
Mr. RICHARD R. DETTLAFF bs,csac
W168S7024 PARKLAND DR
MUSKEGO, WI 53150-9441
Phone number: 414-422-4707
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