Individual
MARY MICELI-WINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-6940
(920) 391-4870
Mailing address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-6940
(920) 391-4870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1198
WI
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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