Kevin A Knudson in Lac Du Flambeau - Addiction (substance Use Disorder)
Kevin A Knudson - NPI 1578691960
Kevin A Knudson is a Addiction (substance Use Disorder) in Lac Du Flambeau, Wisconsin. Kevin A Knudson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Kevin A Knudson is 1578691960. The last update date is 2007-07-09.
Kevin A Knudson's current location address is 533 Peace Pipe Road, Lac Du Flambeau, Wisconsin. You can contact this provider via phone number 7155881511 and fax number 7155883903. The mailing address for Kevin A Knudson is 533 Peace Pipe Road, Lac Du Flambeau, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin A Knudson |
|---|---|
| Address | 533 Peace Pipe Road, Lac Du Flambeau, Wisconsin |
| Phone Number | 7155881511 |
| Fax Number | 7155883903 |
| Sole Proprietor | Y |
| Credentials | CADCIII |
NPI Number Detail
| NPI Number | 1578691960 |
|---|---|
| Provider Enumeration Date | 2007-02-28 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 533 Peace Pipe Road |
|---|---|
| City | Lac Du Flambeau |
| State | Wisconsin (WI) |
| Post Code | 545380189 |
| Phone Number | 7155881511 |
| Fax Number | 7155883903 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 14432 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39373600 | WI | -- |
Post Comment/ Review Below
What is the Kevin A Knudson's 1578691960?
The Kevin A Knudson's NPI (National Provider Identifier) Number is 1578691960. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Kevin A Knudson located?
The Kevin A Knudson is located at 533 Peace Pipe Road, Lac Du Flambeau, WI 545380189.
What is the Kevin A Knudson's specialty and taxonomy code?
The Kevin A Knudson's specialty is Addiction (substance Use Disorder), and the corresponding taxonomy code is 101Ya0400X.
On what date did the Kevin A Knudson receive the assignment of its 1578691960 from the Centers for Medicare & Medicaid Services?
The Kevin A Knudson was issued its 1578691960 by the Centers for Medicare & Medicaid Services on 2007-02-28.
When was the Kevin A Knudson's information last updated?
The Kevin A Knudson's information was last updated on 2007-07-09.
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