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1801188271
DARRYL RAY WHEELER
GREEN BAY, WI
NPI
1801188271
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 15393-132)
Enumeration Date
2011-05-04
Last Update Date
2011-09-02
Business Address
Mr. DARRYL RAY WHEELER CSAC
2979 ALLIED ST
GREEN BAY, WI 54304-5567
Phone number: 262-549-6600
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Mailing Address
Mr. DARRYL RAY WHEELER CSAC
2422 N GRANDVIEW BLVD
WAUKESHA, WI 53188-6105
Phone number: 262-549-6600
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