person
Wanda J Keniston, MS
Addiction (Substance Use Disorder) Counselor in Middleton, Wisconsin
NPI 1457329336

Wanda J Keniston is an Addiction (Substance Use Disorder) Counselor based in Stoughton, WI and is specialized in Addiction (Substance Use Disorder). Wanda J Keniston practices in Middleton, WI and has the professional credentials of MS. The NPI Number for Wanda J Keniston is 1457329336 and holds a License No. 3320 (Wisconsin).

The current practice location address for Wanda J Keniston is 6717 Stone Glen Dr., Middleton, WI and can be reached out via phone at 608-220-0738 and via fax at 608-827-7100.

Location: 6717 Stone Glen Dr., Middleton, WI, 53589-1834
person
Provider Profile Details
NPI Number
1457329336
Provider Name
Wanda J Keniston
Credential
MS
Provider Entity Type
Individual
Gender
Female
Address
6717 Stone Glen Dr., Middleton, WI, 53589-1834
Phone Number
608-220-0738
Fax Number
608-827-7100
Provider Enumeration Date
03/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
40956200 05 WI
institution
Provider Business Practice Location Address Details
Address
6717 Stone Glen Dr.
City
State
Zip
53562
Phone Number
608-220-0738
Fax Number
608-827-7100
person
Provider Business Mailing Address Details
Address
6717 Stone Glen Dr.
City
State
Zip
53562
Phone Number
608-220-0738
Fax Number
608-827-7100
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
3320 (Wisconsin)
Definition
Definition to come...
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