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Individual

RUTH ALICE HOLMQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APSW CSAC CADCIII

Contact information

Practice address
571 COUNTY RD A, GREEN LAKE, WI 54941-9798
(920) 294-4070
(920) 294-4139
Mailing address
PO BOX 588, GREEN LAKE, WI 54941-0588
(920) 294-4070
(920) 294-4139

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12971 132
WI
101YM0800X
Mental Health Counselor
356 121
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40942000
WI
Enumeration date
02/28/2007
Last updated
08/17/2010
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