Organization
MINERVA COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HERING (PROFESSIONAL COUNSELOR)
(715) 579-6205
Entity
Organization
Contact information
Practice address
493 S MAIN ST, FOND DU LAC, WI 54935-5736
(715) 579-6205
Mailing address
493 SOUTH MAIN STREET, FOND DU LAC, WI 54935
(715) 579-6205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1612-226
WI
251S00000X
Community/Behavioral Health Agency
3883-125
WI
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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