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Individual

KERRIE JO LARSONKERKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
1531 S MADISON ST, APPLETON, WI 54915-1800
(920) 738-2000
Mailing address
40 JEWELERS PARK DR STE 200, NEENAH, WI 54956-3893
(920) 205-8336

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2153-132
WI

Other

Enumeration date
10/22/2007
Last updated
02/15/2019
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