Individual
MOLLY C SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT AND SAC-IT
Contact information
Practice address
1111 W WISCONSIN ST, SPARTA, WI 54656-2233
(608) 269-1588
Mailing address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16422
WI
101YM0800X
Mental Health Counselor
4177-226
WI
Other
Enumeration date
11/08/2018
Last updated
12/14/2020
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