CONNIE O MADLOCK

MILWAUKEE, WI
NPI1457858136
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16826-130)
Enumeration Date2018-04-10
Last Update Date2018-04-10
Business Address
CONNIE O MADLOCK
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
Mailing Address
CONNIE O MADLOCK
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
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