ISAAC JAY HENDERSON

WAUKESHA, WI
NPI1962974618
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16416-132)
Enumeration Date2018-12-19
Last Update Date2021-02-01
Business Address
ISAAC JAY HENDERSON CSAC
2000 W BLUEMOUND RD
WAUKESHA, WI 53186-2787
Phone number: 262-246-2732
Mailing Address
ISAAC JAY HENDERSON CSAC
2000 W BLUEMOUND RD
WAUKESHA, WI 53186-2787
Phone number: 262-246-2732
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