CORIE HARGROVE

RACINE, WI
NPI1720124019
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  13772)
Enumeration Date2007-01-30
Last Update Date2012-12-06
Business Address
Mr. CORIE HARGROVE CADC-III
2405 NORTHWESTERN AVE # LL15
RACINE, WI 53404-2534
Phone number: 262-260-8370
Mailing Address
Mr. CORIE HARGROVE CADC-III
1625 DERBY AVE
RACINE, WI 53403-3808
Phone number:
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