Individual
MICHELLE LEE VAN THIEL I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
N9487 COUNTY RD N, APPLETON, WI 54915-9316
(920) 850-7902
Mailing address
N9487 COUNTRY ROAD N, APPLETON, WI 54915
(920) 850-7902
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-7257
WI
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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