Individual
LONNIE M KRUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, SAC-IT
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 437-3540
Mailing address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 437-3540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15385-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15835-130
SAC-IT
WI
Enumeration date
10/19/2011
Last updated
10/19/2011
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