Individual
KIMBERLY ANN SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
555 REDBIRD CIR, DE PERE, WI 54115-7977
(920) 338-6830
(920) 338-6879
Mailing address
PO BOX 22040, GREEN BAY, WI 54305-2040
(920) 445-7220
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4736-125
WI
Other
Enumeration date
08/21/2014
Last updated
06/18/2020
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