Individual
AMANDA RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1716 LAWRENCE DR STE 107, DE PERE, WI 54115-9108
(920) 570-6339
(920) 243-1792
Mailing address
3416 N ASSOCIATION DR, APPLETON, WI 54914-1479
(920) 364-9078
(920) 243-1792
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3948-226
WI
101YP2500X
Professional Counselor
7889-125
WI
Other
Enumeration date
06/06/2019
Last updated
03/24/2022
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