Individual
TRACY HANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1531 S MADISON ST, SUITE 580, APPLETON, WI 54915-1800
(920) 831-8437
Mailing address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1464
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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