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Organization
PHOENIX RISING LLC
Active
Organization
PHOENIX RISING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRYSTAL STEPHANY MA,LPC (OWNER)
(920) 251-4214
Entity
Organization
Contact information
Practice address
N7640 COUNTY ROAD WH STE 200, FOND DU LAC, WI 54937-7832
(920) 933-3736
Mailing address
N7640 COUNTY ROAD WH STE 200, FOND DU LAC, WI 54937-7832
(920) 933-3736
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6151-125
WI
Other
Enumeration date
07/20/2016
Last updated
04/07/2017
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