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General NPI Number Information
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NPI Number | 1669006714
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Entity Type | Individual
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Provider Name | RONALD DANIEL LESSARD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 335 E MONROE AVE FL CENTER3
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City | BARRON
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State | WI
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Zip | 54812-1479
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Country | US
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Telephone | 715-537-6382
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Fax |
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Provider Business Mailing Address
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Address Line | 335 E MONROE AVE FL CENTER3
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City | BARRON
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State | WI
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Zip | 54812-1479
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Country | US
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Telephone | 715-537-6382
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1576
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License Number State | WI
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