Individual
PATRICIA L VANDERMAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC ,CSAC
Contact information
Practice address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
Mailing address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4431-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WI
Enumeration date
08/26/2010
Last updated
08/26/2010
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