Individual
MICHELLE R. HAESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAPSW, CSAC
Contact information
Practice address
W9071 FOREST DR, PLYMOUTH, WI 53073-0031
(920) 526-3244
Mailing address
P.O. BOX 31, W9071 FOREST DR, PLYMOUTH, WI 53073-0031
(920) 526-3244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15615-130
WI
104100000X
Social Worker
128008-121
WI
Other
Enumeration date
10/05/2009
Last updated
12/09/2013
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