JEROME MUTCHIE

APPLETON, WI
NPI1831441039
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16720-130)
Enumeration Date2012-10-11
Last Update Date2014-11-25
Business Address
-- JEROME MUTCHIE SAC
1000 N LYNNDALE DR C
APPLETON, WI 54914-3057
Phone number: 920-735-9010
Mailing Address
-- JEROME MUTCHIE SAC
1000 N LYNNDALE DR C
APPLETON, WI 54914-3057
Phone number: 920-735-9010
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