Individual
SAMANTHA NICOLE KORNOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, APSW, CSAC
Contact information
Practice address
1701 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 498-8600
Mailing address
1701 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 498-8600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WI
101YM0800X
Mental Health Counselor
—
WI
Other
Enumeration date
05/26/2015
Last updated
12/08/2021
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