Individual
AMANDA JOY KOHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, SAC-IT
Contact information
Practice address
6040 W LISBON AVE STE 200, MILWAUKEE, WI 53210-2116
(414) 447-9890
Mailing address
3442 N 95TH ST, MILWAUKEE, WI 53222-3556
(414) 354-3300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13847-130
WI
101YP2500X
Professional Counselor
77-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13847-130
SAC-IT
WI
01
—
77-226
PROFESSIONAL COUNSELOR TR
WI
Enumeration date
03/08/2007
Last updated
09/11/2025
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