Individual
MARY BAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SACIT
Contact information
Practice address
201 S GLENRIDGE CT, APPLETON, WI 54914-3905
(920) 731-3981
Mailing address
607 W 7TH ST, APPLETON, WI 54911-5923
(920) 739-3235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16972-130
WI
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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