Individual
JOANNE M KLYSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 W MASON ST, GREEN BAY, WI 54303-1858
(920) 437-8256
(920) 437-1188
Mailing address
1061 W MASON ST, GREEN BAY, WI 54303-1858
(920) 437-8256
(920) 437-1188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6031-125
WI
101YP2500X
Professional Counselor
6031-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6031-125
WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
02/11/2014
Last updated
06/20/2023
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