person
Kenneth R Ninham, MSE
Addiction (Substance Use Disorder) Counselor in Lac Du Flambeau, Wisconsin
NPI 1992795223

Kenneth R Ninham is an Addiction (Substance Use Disorder) Counselor based in Lac Du Flambeau, WI and is specialized in Addiction (Substance Use Disorder). Kenneth R Ninham practices in Lac Du Flambeau, WI and has the professional credentials of MSE. The NPI Number for Kenneth R Ninham is 1992795223 and holds a License No. 2624-120 (Wisconsin).

The current practice location address for Kenneth R Ninham is 129 Old Abe Rd, Lac Du Flambeau, WI and can be reached out via phone at 715-588-3371 and via fax at 715-588-2031.

Location: 129 Old Abe Rd, Lac Du Flambeau, WI, 54538-9386
person
Provider Profile Details
NPI Number
1992795223
Provider Name
Kenneth R Ninham
Credential
MSE
Provider Entity Type
Individual
Gender
Male
Address
129 Old Abe Rd, Lac Du Flambeau, WI, 54538-9386
Phone Number
715-588-3371
Fax Number
715-588-2031
Provider Enumeration Date
10/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
39231600 05 WI
institution
Provider Business Practice Location Address Details
Address
129 Old Abe Rd
City
State
Zip
54538-9386
Phone Number
715-588-3371
Fax Number
715-588-2031
person
Provider Business Mailing Address Details
Address
129 Old Abe Rd
City
State
Zip
54538-9386
Phone Number
715-588-3371
Fax Number
715-588-2031
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
1060-132 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
11915-134 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2624-120 (Wisconsin)
Definition
Definition to come...
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