Doctor Name: | JORDAN CHARBONEAU |
NPI Number: | 1720263577 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 561 N 15th St Marquette University 7cs Community Counseling Clinics Milwaukee, WI - 532332237 |
Business Phone Number: | 4142885889 |
Business Fax Number: | |
Mailing Address: | 561 N 15th St, Rm 150 MILWAUKEE |
State: | WI |
Postal Code: | 532332237 |
Phone Number: | 4142884556 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |