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General NPI Number Information
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NPI Number | 1326113275
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Entity Type | Individual
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Provider Name | WARREN D STOUFFER CADC II
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24670 STATE RD 35 70 SUITE 1200 AURORA COMMUNITY COUNSELING EMPLOYEE SUPPORT
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City | SIREN
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State | WI
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Zip | 54872
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Country | US
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Telephone | 715-349-7233
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Fax | 715-349-7205
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Provider Business Mailing Address
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Address Line | PO BOX 48
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City | SHELL LAKE
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State | WI
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Zip | 54871
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Country | US
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Telephone | 715-468-7957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 12425
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License Number State | WI
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