Individual
STACIE NAGORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4351 W COLLEGE AVE STE 410, APPLETON, WI 54914
(800) 438-1772
(262) 345-5562
Mailing address
3160 REVERE RD, PLOVER, WI 54467-3631
(715) 570-7267
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6468-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10049991
—
WI
Enumeration date
12/01/2015
Last updated
08/20/2018
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