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Individual

JESSICA DANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
911 JOYCE ST APT 305, KAUKAUNA, WI 54130-1057
(920) 389-1585
Mailing address
911 JOYCE ST APT 305, KAUKAUNA, WI 54130-1057

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111230
CERTIFIED SEX ADDICTION COUNSELOR
Enumeration date
09/29/2022
Last updated
09/29/2022
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