Organization
KRISTA DEMUTH LLC
Active
Other names
Krista Demuth LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA J DEMUTH MS, LPC (OWNER)
(715) 410-1280
Entity
Organization
Contact information
Practice address
815 DAVIS ST, HAMMOND, WI 54015-9808
(612) 567-9881
Mailing address
625 KLEIN DR, HAMMOND, WI 54015-9798
(715) 410-1280
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059323
—
WI
05
—
1083085914
—
WI
Enumeration date
04/06/2022
Last updated
08/27/2022
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