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1982154779
KRYSTAL BOURGEOIS
MILWAUKEE, WI
NPI
1982154779
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16764-130)
Enumeration Date
2016-10-05
Last Update Date
2017-02-16
Business Address
Ms. KRYSTAL BOURGEOIS BSW, SAC-IT
2677 N 40TH ST
MILWAUKEE, WI 53210-2505
Phone number: 414-447-1965
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Mailing Address
Ms. KRYSTAL BOURGEOIS BSW, SAC-IT
8801 W OKLAHOMA AVE APT 210
MILWAUKEE, WI 53227-4571
Phone number: 414-552-9244
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