Organization
RAEANN WICHLACZ
Active
Other names
Courage To Change Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAEANN WICHLACZ CADC III (OWNER)
(715) 223-0480
Entity
Organization
Contact information
Practice address
106 GALVIN ROAD, ABBOTSFORD, WI 54405
(715) 223-0480
(715) 223-1611
Mailing address
PO BOX 447, 106 GALVIN ROAD, ABBOTSFORD, WI 54405
(715) 223-0480
(715) 223-1611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42215300
—
WI
Enumeration date
11/30/2005
Last updated
06/13/2008
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