Individual
JILL M GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
(920) 720-3719
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15982
WI
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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