MR. VERNON FORMAN, CERTIFICATIONS

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1952403966

Practice Address

722 S SPRING ST
Port Washington, WI 53074

Phone: (262) 483-0048

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes 1701 (WI)

Frequently Asked Questions

NPI 1952403966 is the National Provider Identifier for MR. VERNON FORMAN, CERTIFICATIONS, a Counselor - Addiction (Substance Use Disorder) provider located in Port Washington, WI. This NPI was enumerated on September 1, 2006.
MR. VERNON FORMAN, CERTIFICATIONS practices at 722 S SPRING ST, Port Washington, WI 53074.

Quick Facts

NPI
1952403966
Type
Individual
Enumerated
Sep 1, 2006
Last Updated
Jul 8, 2007

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