Individual
JEANETTE KSIONEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Mailing address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1155132
WI
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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