Individual
CORY R KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC-IT, SAC-IT
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Mailing address
W7210 COUNTY ROAD V, LAKE MILLS, WI 53551-9645
(920) 648-5613
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17863-130
WI
101YP2500X
Professional Counselor
Primary
3039-226
WI
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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