Individual
MICHELLE ENGLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
Mailing address
3012 WRIGHT AVE, RACINE, WI 53405-5047
(262) 880-2243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17000-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097229
—
WI
Enumeration date
02/05/2020
Last updated
04/17/2024
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