Individual provider · Type 1 NPI
Wallace Edward Brandies Jr., CSAC ICS
Addiction (Substance Use Disorder) Counselor · Racine, WI
NPI number
1811595671
Active
Practice location
1717 Taylor Ave
Racine, WI 53403-2405
Fax (262) 638-6540
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 15295-132 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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- Elizabeth Ann Polo, BS, CSAC, CSITAddiction (Substance Use Disorder) Counselor Racine, WI NPI 1215205612
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About NPI 1811595671
Wallace Edward Brandies Jr., CSAC ICS's National Provider Identifier is 1811595671, issued on Oct 14, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Racine, WI. The record was last updated on Oct 14, 2020.