Individual
KAITLYN M AMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
141 SIEGLER ST, GREEN BAY, WI 54303-2635
(920) 433-3372
Mailing address
PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
132934
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619689114
—
WI
Enumeration date
12/16/2022
Last updated
08/29/2024
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