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Individual

RYAN D KNUTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSAC, LPC, ICS-IT

Contact information

Practice address
571 BRAUND ST, ONALASKA, WI 54650
(608) 785-7000
(608) 785-7477
Mailing address
1333 TRAVIS ST, LA CROSSE, WI 54601-6343
(608) 386-6080

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16064
WI
101YP2500X
Professional Counselor
Primary
2777
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100065209
WI
Enumeration date
03/10/2017
Last updated
07/23/2018
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