Individual
BREANNE MARIE VANLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
151 E BADGER RD, MADISON, WI 53713-2708
(608) 250-2512
Mailing address
310 W MACKIE ST, BEAVER DAM, WI 53916-1638
(608) 250-2512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18375-130
WI
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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