Organization
WOODLAN YOUTH AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LINDA PHELPS MS LPC SAC (ASS. ADMINISTRATOR)
(715) 202-0434
Entity
Organization
Contact information
Practice address
20499 270TH ST., CORNELL, WI 54732-0201
(715) 202-0434
Mailing address
PO BOX 201, CORNELL, WI 54732-0201
(715) 202-0434
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3739-125
STATE OF WISCONSIN LICENSINGAND REGULATION
WI
Enumeration date
01/06/2017
Last updated
01/06/2017
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