Individual
AMANDA LINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 S COMMERCIAL ST, NEENAH, WI 54956-6152
(920) 722-8150
Mailing address
1509 S COMMERCIAL ST, NEENAH, WI 54956-6152
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2541-226
WI
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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