Individual
SHAWNA KLETZINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 WASHINGTON ST, WAUSAU, WI 54403-5543
(715) 845-3637
(715) 845-1977
Mailing address
210 WASHINGTON ST, WAUSAU, WI 54403-5543
(715) 845-3637
(715) 845-1977
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18483130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18453-130
SAC-IT
WI
Enumeration date
02/28/2019
Last updated
02/28/2019
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