Individual
CYNTHIA LEIGH TIESLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2339 CEDAR RDG, SUITE 4, GREEN BAY, WI 54313-5700
(920) 497-6161
(920) 498-0476
Mailing address
2339 CEDAR RDG, SUITE 4, GREEN BAY, WI 54313-5700
(920) 497-6161
(920) 498-0476
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
378-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39284900
—
WI
Enumeration date
12/20/2007
Last updated
12/20/2007
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