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1831564814
REGINALD JOHNSON
MILWAUKEE, WI
NPI
1831564814
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16415-130)
Enumeration Date
2015-12-02
Last Update Date
2015-12-02
Business Address
-- REGINALD JOHNSON SCA-IT
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
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Mailing Address
-- REGINALD JOHNSON SCA-IT
7314 W BURLEIGH ST APT 3
MILWAUKEE, WI 53210-1082
Phone number: 414-447-7208
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