Individual
MICHAEL IZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LAC
Contact information
Practice address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Mailing address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15586132
WI
1041C0700X
Clinical Social Worker
Primary
7762123
WI
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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