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Individual

MRS. KATHLEEN D PAMMER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPC, CADC

Contact information

Practice address
620 N 12TH AVE, STURGEON BAY, WI 54235-1249
(920) 743-9554
Mailing address
620 N 12TH AVE, STURGEON BAY, WI 54235-1249
(920) 743-9554

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3104-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43589400
WI
Enumeration date
02/23/2006
Last updated
07/08/2007
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