Healthcare Provider Details

I. General information

NPI: 1902688112
Provider Name (Legal Business Name): MRS. SANDRA MARIE PIOTROWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W5361 COUNTY ROAD KK STE D
APPLETON WI
54915-7271
US

IV. Provider business mailing address

W5361 COUNTY ROAD KK STE D
APPLETON WI
54915-7271
US

V. Phone/Fax

Practice location:
  • Phone: 920-460-9755
  • Fax:
Mailing address:
  • Phone: 920-460-9755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: