Individual provider · Type 1 NPI

Joshua David Gandolf, CSAC

Addiction (Substance Use Disorder) Counselor · Menasha, WI

NPI number 1336171891 Active

Practice location

1201 Tuckaway Ln
Menasha, WI 54952-1704

Call (920) 733-4277 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X14670 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1336171891

Joshua David Gandolf, CSAC's National Provider Identifier is 1336171891, issued on Jul 7, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Menasha, WI. The record was last updated on Jul 8, 2007.