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Individual

KARI B DECORAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC, SAC-IT

Contact information

Practice address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378
Mailing address
9433 COUNTY RD J, MINOCQUA, WI 54548-9318
(715) 356-5377
(715) 356-5378

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16107-130
WI
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100027386
WI
Enumeration date
01/31/2012
Last updated
03/05/2013
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