| Doctor Name: | RONALD MACLIN |
| NPI Number: | 1033371349 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSAC |
| License Number: | 14815-132 |
| Business Practice Address: | 2422 N Grandview Blvd Waukesha, WI - 531886105 |
| Business Phone Number: | 2625496600 |
| Business Fax Number: | 2625496698 |
| Mailing Address: | 2422 N Grandview Blvd, WAUKESHA |
| State: | WI |
| Postal Code: | 531886105 |
| Phone Number: | 2625496600 |
| Fax Number: | 2625496698 |
| NPI Enumeration Date: | 06/27/2008 |
| NPI Last Update Date: | 10/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 14815-132 |
| 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: | |