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Individual

ANNTIONETTE M FELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
2005 HIGHLAND AVE, EAU CLAIRE, WI 54701-4455
(715) 832-5454
(715) 832-2991
Mailing address
2005 HIGHLAND AVE, EAU CLAIRE, WI 54701-4455
(715) 832-5454
(715) 832-2991

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
NA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13209
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39374200
WI
01
56001
SECURITY HEALTH PLAN
WI
01
637871032291
PREFERRED ONE
MN
Enumeration date
05/03/2006
Last updated
05/22/2008
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