Individual
CYNTHIA A. GRIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC III,CCS II
Contact information
Practice address
1201 TUCKAWAY LN, MENASHA, WI 54952-1704
(920) 733-4443
(920) 733-4796
Mailing address
4680 LAKE RD, OSHKOSH, WI 54902-7500
(920) 235-3521
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1888
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39360500
—
WI
Enumeration date
02/09/2007
Last updated
07/09/2007
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