Individual
MRS. AUDREY ELAINE MARCHILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SACIT
Contact information
Practice address
3447 BEE LN, BELOIT, WI 53511-1901
(608) 361-7200
(608) 361-7201
Mailing address
3447 BEE LN, BELOIT, WI 53511-1901
(608) 361-7200
(608) 361-7201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17808-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17808-130
SACIT
WI
Enumeration date
10/03/2017
Last updated
10/03/2017
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