Individual
NHIA MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
5601 W GRANDE MARKET DR STE N, APPLETON, WI 54913-8511
(920) 903-1060
(920) 903-1164
Mailing address
5601 W GRANDE MARKET DR STE N, APPLETON, WI 54913-8511
(920) 903-1060
(920) 903-1164
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
129550-121
WI
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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