Individual
NICOLE LUCHTERHAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Mailing address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19175-130
WI
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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