Individual
HANNAH DOMASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5581
Mailing address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5581
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2021
Last updated
02/22/2022
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