Organization
REFRESH MIDWEST OPERATIONS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY NEVINS MS, LPC (ADMINISTRATIVE DIRECTOR)
(715) 381-1980
Entity
Organization
Contact information
Practice address
2501 HANLEY RD STE 202, HUDSON, WI 54016-8705
(715) 381-1980
(715) 381-1906
Mailing address
2501 HANLEY RD STE 202, HUDSON, WI 54016-8705
(715) 381-1980
(715) 381-1906
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1436-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053463976
—
WI
05
—
1245667633
—
WI
05
—
1336248137
—
WI
05
—
1427000991
—
WI
05
—
1518208206
—
WI
05
—
1649514803
—
WI
05
—
1669822763
—
WI
05
—
1689947384
—
WI
05
—
171-004-3070
—
WI
Enumeration date
08/17/2017
Last updated
05/08/2018
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