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Individual

MS. JILLIAN LEE PALMBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
17632-130

Contact information

Practice address
3301 N BALLARD RD, STE B, APPLETON, WI 54911-8928
(920) 733-4443
(920) 733-4796
Mailing address
2811 W GLENPARK DR, APPLETON, WI 54914-1571
(920) 538-6261

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17632-130
WI

Other

Enumeration date
02/22/2016
Last updated
02/22/2016
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