Individual
KATLYNNE MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
860 HANSEN RD, GREEN BAY, WI 54304-5324
(920) 309-6651
Mailing address
860 HANSEN RD, GREEN BAY, WI 54304-5324
(920) 309-6651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
131891
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205592128
—
WI
01
—
131891
STATE LICENSE
WI
Enumeration date
11/15/2021
Last updated
11/21/2024
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