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1366720484
FRED A BOSWELL
MILWAUKEE, WI
NPI
1366720484
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 11950-132)
Enumeration Date
2011-07-22
Last Update Date
2014-04-30
Business Address
-- FRED A BOSWELL CSAC, ICS
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
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Mailing Address
-- FRED A BOSWELL CSAC, ICS
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
Copy
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