Individual
MRS. PAULINE E ORTLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CSAC, ICS
Contact information
Practice address
1717 TAYLOR AVENUE, RACINE, WI 53403
(262) 638-6744
(262) 638-6540
Mailing address
13922 WILMOT RD, KENOSHA, WI 53142-7924
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10709-132
WI
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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