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General NPI Number Information
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NPI Number | 1760629026
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Entity Type | Individual
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Provider Name | KIM MAROHL MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 321 SAINT GEORGE ST
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City | GREEN BAY
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State | WI
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Zip | 54302-1310
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Country | US
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Telephone | 920-278-2620
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Fax | 920-278-7886
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Provider Business Mailing Address
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Address Line | 321 SAINT GEORGE ST
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City | GREEN BAY
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State | WI
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Zip | 54302-1310
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Country | US
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Telephone | 920-278-2620
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Fax | 920-278-7886
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4239-125
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License Number State | WI
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