Individual
MS. MICHELLE LYNN IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW,CSAC
Contact information
Practice address
5583 WATERFORD LN STE D, APPLETON, WI 54913-8441
(920) 733-2065
Mailing address
1194 BLAKES WAY, MENASHA, WI 54952
(920) 205-2401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
682
WI
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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