Individual
MS. AUTUMN LEE DANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
627 BAY SHORE DR, OSHKOSH, WI 54901-5228
(920) 426-8988
Mailing address
2560 HEARTHSTONE DR, OSHKOSH, WI 54901-1598
(920) 379-6598
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3923-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100013778
—
WI
Enumeration date
10/08/2009
Last updated
12/07/2011
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