| Doctor Name: | SAMMY JOE RANGEL |
| NPI Number: | 1013166891 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSAC |
| License Number: | 14088-132 |
| Business Practice Address: | 840 Lake Ave 101 Racine, WI - 534031566 |
| Business Phone Number: | 2626348688 |
| Business Fax Number: | 2626347547 |
| Mailing Address: | 840 Lake Ave, 101 RACINE |
| State: | WI |
| Postal Code: | 534031566 |
| Phone Number: | 2626348688 |
| Fax Number: | 2626347547 |
| NPI Enumeration Date: | 09/16/2008 |
| NPI Last Update Date: | 09/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 14088-132 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |