Individual
JAMIE-LEE NIETUPSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 652-2408
Mailing address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 652-2408
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4000-226
WI
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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