Individual
KIRSTIN OPGENORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
926 S 8TH ST, MANITOWOC, WI 54220-4535
(920) 683-4230
Mailing address
926 S 8TH ST, MANITOWOC, WI 54220-4535
(920) 683-4230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19724-130
WI
1041C0700X
Clinical Social Worker
Primary
132865-121
WI
Other
Enumeration date
06/09/2022
Last updated
04/21/2023
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