person
Jerome Mutchie, SAC
Addiction (Substance Use Disorder) Counselor in Appleton, Wisconsin
NPI 1831441039

Jerome Mutchie is an Addiction (Substance Use Disorder) Counselor based in Appleton, WI and is specialized in Addiction (Substance Use Disorder). Jerome Mutchie practices in Appleton, WI and has the professional credentials of SAC. The NPI Number for Jerome Mutchie is 1831441039 and holds a License No. 16720-130 (Wisconsin).

The current practice location address for Jerome Mutchie is 1000 N Lynndale Dr, Appleton, WI and can be reached out via phone at 920-735-9010 and via fax at 920-735-9050.

Location: 1000 N Lynndale Dr, Appleton, WI, 54914-3057
person
Provider Profile Details
NPI Number
1831441039
Provider Name
Jerome Mutchie
Credential
SAC
Provider Entity Type
Individual
Gender
Male
Address
1000 N Lynndale Dr, Appleton, WI, 54914-3057
Phone Number
920-735-9010
Fax Number
920-735-9050
Provider Enumeration Date
10/11/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
15933-131 01 WI STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
1000 N Lynndale Dr
City
State
Zip
54914-3057
Phone Number
920-735-9010
Fax Number
920-735-9050
person
Provider Business Mailing Address Details
Address
1000 N Lynndale Dr
City
State
Zip
54914-3057
Phone Number
920-735-9010
Fax Number
920-735-9050
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
16720-130 (Wisconsin)
Definition
Definition to come...
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