Organization
WI AWAKEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE COATES MS, LPC, SAC (THERAPIST)
(262) 379-0942
Entity
Organization
Contact information
Practice address
157 S PINE ST, BURLINGTON, WI 53105-1911
(262) 342-5188
Mailing address
PO BOX 189, BURLINGTON, WI 53105-0189
(262) 342-5188
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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