Individual
MRS. PATRICIA A USTIANOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCIII
Contact information
Practice address
533 PEACE PIPE ROAD, LAC DU FLAMBEAU, WI 54538-0189
(715) 588-1511
(715) 588-3903
Mailing address
P.O. BOX 189, 533 PEACE PIPE ROAD, LAC DU FLAMBEAU, WI 54538-0189
(715) 588-1511
(715) 588-3903
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13667
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1765
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39351000
—
WI
Enumeration date
02/28/2007
Last updated
07/09/2007
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