Individual
STEPHANIE M COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 MAIN ST STE 200, MENASHA, WI 54952-3181
(920) 202-6170
Mailing address
130 MAIN ST STE 200, MENASHA, WI 54952-3181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
WI
Other
Enumeration date
05/17/2018
Last updated
06/16/2018
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