Individual
AMY PROUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
6292-125
WI
Other
Enumeration date
11/26/2014
Last updated
02/25/2025
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