Individual
DEBORAH SAMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT, LMT,E-RYT
Contact information
Practice address
1477 KENWOOD DR STE 200, MENASHA, WI 54952-1160
(920) 215-1533
Mailing address
1477 KENWOOD DR STE 200, MENASHA, WI 54952-1160
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12389-125
WI
101YP2500X
Professional Counselor
Primary
7702-226
WI
225700000X
Massage Therapist
4800-146
WI
Other
Enumeration date
12/12/2023
Last updated
04/08/2026
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