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General NPI Number Information
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NPI Number | 1710474978
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Entity Type | Organization
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Legal Business Name | INNER STRENGTH COUNSELING & RECOVERY LLC
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 130 MAIN ST STE 200
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City | MENASHA
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State | WI
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Zip | 54952-3181
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Country | US
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Telephone | 920-257-6923
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Fax |
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Provider Business Mailing Address
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Address Line | 705 MANCHESTER RD
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City | NEENAH
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State | WI
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Zip | 54956-4909
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Country | US
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Telephone | 920-486-1373
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICIAN
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Name | DR. TERALYN SELL
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Credential | PHD
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Telephone | 920-257-6923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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