Individual
LAURA EICHENOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4125 N 124TH ST STE AANDB, BROOKFIELD, WI 53005-1837
(920) 857-9041
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
471-140
WI
Other
Enumeration date
12/16/2021
Last updated
12/17/2021
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