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1760516215
CLEM RICHARDSON
MILWAUKEE, WI
NPI
1760516215
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 14455132)
Enumeration Date
2007-03-15
Last Update Date
2007-07-08
Business Address
Mr. CLEM RICHARDSON BS
6040 W LISBON AVE
MILWAUKEE, WI 53210-2116
Phone number: 414-447-9890
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Mailing Address
Mr. CLEM RICHARDSON BS
6040 W LISBON AVE
MILWAUKEE, WI 53210-2116
Phone number: 414-447-9890
Copy
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