Individual
AMANDA JOANN DEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4655 N PORT WASHINGTON RD, GLENDALE, WI 53212-1004
(414) 266-3339
(414) 247-1875
Mailing address
4655 N PORT WASHINGTON RD, GLENDALE, WI 53212-1004
(414) 266-3339
(414) 247-1875
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4352-226
WI
101YP2500X
Professional Counselor
Primary
8772-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19842654
—
WI
Enumeration date
04/06/2020
Last updated
03/17/2022
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