Individual
KODI DENISE BARTHELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
23 W SCOTT ST, FOND DU LAC, WI 54935-2342
(920) 926-0101
(920) 926-0060
Mailing address
23 W SCOTT ST, FOND DU LAC, WI 54935-2342
(920) 926-0101
(920) 926-0060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18609-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18609-130
—
WI
Enumeration date
06/15/2018
Last updated
06/15/2018
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