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475 E Merrill Ave Fond Du Lac WI 54935-3749 | |
(262) 345-5599 | |
(262) 345-5608 |
Full Name | |
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Speciality | Counselor - Professional |
Location | 475 E Merrill Ave, Fond Du Lac, Wisconsin |
Authorized Official Name and Position | Andrea Semmann (OPERATIONS DIRECTOR) |
Authorized Official Contact | 2623455560 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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W175n11120 Stonewood Dr Germantown WI 53022-6511 Ph: (262) 345-5560 | 475 E Merrill Ave Fond Du Lac WI 54935-3749 Ph: (262) 345-5599 |
NPI Number | 1598143059 |
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Provider Enumeration Date | 05/15/2015 |
Last Update Date | 05/15/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598143059 | NPI | - | NPPES |
42171800 | Medicaid | WI |
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