Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 11504 | WI |
NPI | 1003906132 |
---|---|
Provider Name | Cathie I Abel |
First Address | Woodruff, WI 54568 |
Second Address | Woodruff, WI 54568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39393700 | (05) | WI |