Individual
AMANDA R CARDINAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
123 N OAKLAND AVE, GREEN BAY, WI 54303-2831
(920) 770-4088
(651) 705-0026
Mailing address
123 N OAKLAND AVE, GREEN BAY, WI 54303-2831
(920) 770-4088
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6319
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
6319-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100068903
—
WI
Enumeration date
05/12/2017
Last updated
04/23/2024
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