Individual
AMYBETH MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4726 N GREEN BAY RD, RACINE, WI 53404-1108
(262) 638-6508
Mailing address
4726 N GREEN BAY RD, RACINE, WI 53404-1108
(262) 638-6508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17473-130
WI
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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