Individual
BREANA J SEUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC-IT, SAC-IT
Contact information
Practice address
W2333 COMMERCIAL ST, POY SIPPI, WI 54967-8108
(920) 379-0009
Mailing address
PO BOX 386, POY SIPPI, WI 54967-0386
(920) 379-0009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
WI
101YP2500X
Professional Counselor
Primary
8115-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091871
—
WI
Enumeration date
06/17/2019
Last updated
10/13/2022
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