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Individual

AMBER E FALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-8203
Mailing address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-8203

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14294
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15313-132
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001162
WI
05
42024400
WI
Enumeration date
07/28/2006
Last updated
01/14/2020
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