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General NPI Number Information
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NPI Number | 1770978173
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Entity Type | Individual
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Provider Name | LANA WINTER SAC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 3144 VANZILE RD
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City | CRANDON
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State | WI
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Zip | 54520
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Country | US
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Telephone | 725-478-5180
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Fax |
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Provider Business Mailing Address
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Address Line | 603 COOLIDGE ST
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City | TOMAHAWK
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State | WI
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Zip | 54487-1610
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Country | US
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Telephone | 715-360-8264
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Fax |
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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 | 16124-131
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License Number State | WI
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