Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15861-130 | WI |
N | 101YM0800X | Mental Health Counselor |
NPI | 1003128638 |
---|---|
Provider Name | Nicholas Paul Hayon |
First Address | West Allis, WI 53227-2136 |
Second Address | West Allis, WI 53227-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2010 |
Last Update Date | 12/07/2010 |