Individual
AMY S JOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
1044 S PARK AVE, FOND DU LAC, WI 54935-8031
(920) 539-9427
Mailing address
1044 S PARK AVE, FOND DU LAC, WI 54935-8031
(920) 539-9427
(920) 926-8885
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2137
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
162616
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2137
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
38635
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
4127
VA
Other
Enumeration date
08/08/2006
Last updated
12/28/2023
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