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Individual

IVY NOEL SUTEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
1557 CLEVELAND AVENUE, MARINETTE, WI 54143
(715) 732-6868
(715) 732-6866
Mailing address
1557 CLEVELAND AVENUE, MARINETTE, WI 54143
(715) 732-6868
(715) 732-6866

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17091-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
2-01960
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18963130
STATE OF WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
10/04/2019
Last updated
11/02/2023
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