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General NPI Number Information
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NPI Number | 1194449652
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Entity Type | Individual
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Provider Name | EMILY PORTSCHY SACIT
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Gender | Female
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1102 W 1ST ST
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City | WALDO
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State | WI
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Zip | 53093-1309
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Country | US
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Telephone | 920-894-1374
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Fax | 920-894-1373
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Provider Business Mailing Address
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Address Line | PO BOX 347
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City | KIEL
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State | WI
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Zip | 53042-0347
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Country | US
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Telephone | 920-894-1374
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Fax | 920-894-1373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 19408
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License Number State | WI
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