Individual
MRS. SAMANTHA IRENE FERYANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
414 BROADWAY ST STE 101, BARABOO, WI 53913-2488
(608) 448-1011
Mailing address
414 BROADWAY ST STE 101, BARABOO, WI 53913-2488
(608) 448-1011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6635-125
WI
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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