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1538464136
DWIGHT JOHNSON
MILWAUKEE, WI
NPI
1538464136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 15616-131)
Enumeration Date
2011-01-13
Last Update Date
2011-01-13
Business Address
Mr. DWIGHT JOHNSON SAC
6815 N 68TH STREET
MILWAUKEE, WI 53216
Phone number: 414-466-3204
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Mailing Address
Mr. DWIGHT JOHNSON SAC
2462 N 5TH ST
MILWAUKEE, WI 53212-2704
Phone number: 414-466-3204
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