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General NPI Number Information
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NPI Number | 1932302718
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Entity Type | Individual
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Provider Name | WENDELL J. HARRIS M.S. -CADC-I
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2821 N 4TH ST SUITE 224
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City | MILWAUKEE
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State | WI
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Zip | 53212-2362
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Country | US
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Telephone | 414-265-5538
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Fax | 414-265-4533
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Provider Business Mailing Address
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Address Line | 2821 N 4TH ST SUITE 224
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City | MILWAUKEE
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State | WI
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Zip | 53212-2362
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Country | US
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Telephone | 414-265-5538
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Fax | 414-265-4533
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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 | 15370-130
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License Number State | WI
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