Individual
MISS AMY REBECCA CISAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE NCC
Contact information
Practice address
300 CROOKS STREET, GREEN BAY, WI 54301
(920) 436-6800
(920) 432-5966
Mailing address
PO BOX 22308, 300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3819-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43578500
—
WI
Enumeration date
10/04/2006
Last updated
12/08/2021
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