Individual
ASHLEY M GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8050
(715) 732-8015
Mailing address
PO BOX 735044, CHICAGO, IL 60673
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
129618-121
WI
1041C0700X
Clinical Social Worker
Primary
9378-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100093971
—
WI
Enumeration date
10/07/2019
Last updated
05/23/2024
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