Individual
NANCY K BICKNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC SAC
Contact information
Practice address
104 N 1ST ST, SUITE 3, WATERTOWN, WI 53094-3754
(920) 261-2199
Mailing address
PO BOX 131, SUITE 3, WATERTOWN, WI 53094-0131
(920) 261-2199
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11437-131
WI
101YM0800X
Mental Health Counselor
Primary
3034-125
WI
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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