Bruce A Wilber JR.
Addiction Counselor (Substance Use Disorder)
N2150 Kesaehkahtek Rd
Gresham
, Wisconsin 54128-9602
Bruce A Wilber JR.
Addiction Counselor (Substance Use Disorder)
N2150 Kesaehkahtek Rd
Gresham
, Wisconsin 54128-9602
(715) 799-3836
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
Languages spoken
- English
Location
First Address
- Bruce A Wilber JR.
- N2150 Kesaehkahtek Rd
- Gresham, WI
- Zip : 54128-9602
- Fax : (715) 799-3836
- Phone : (715) 799-3835
Second Address
- Bruce A Wilber JR.
- N2150 Kesaehkahtek Rd
- Gresham, WI
- Zip : 54128-9602
- Fax : (715) 799-3836
- Phone : (715) 799-3835
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15433131 | WI |
National Provider Identifier
| NPI | 1003063157 |
|---|---|
| Provider Name | Bruce A Wilber JR. |
| First Address | Gresham, WI 54128-9602 |
| Second Address | Gresham, WI 54128-9602 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/08/2008 |
| Last Update Date | 20/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 41162800 | (05) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.