KELLAN CHRISTIAN HENNING

FOND DU LAC, WI
NPI1740050657
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  20252-130)
Enumeration Date2024-01-03
Last Update Date2024-01-03
Business Address
KELLAN CHRISTIAN HENNING
23 W SCOTT ST
FOND DU LAC, WI 54935-2342
Phone number: 920-926-0101
Mailing Address
KELLAN CHRISTIAN HENNING
8444 N 90TH ST STE 100
SCOTTSDALE, AZ 85258-4437
Phone number: 480-977-1438
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