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NPI Code Detail

MEDICARE: MS. KAY L CHRISTIANSON CSAC CLINICAL SUBSTA

MEDICARE:  MS. KAY L CHRISTIANSON  CSAC CLINICAL SUBSTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor13885132WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578777249
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAY L CHRISTIANSON CSAC CLINICAL SUBSTA
Provider Business Mailing Address
First Line : 23 W SCOTT ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2342
Country : US
Telephone Number : 920-926-0101
Fax Number : 920-926-0060
Provider Business Practice Location Address
First Line : 23 W SCOTT ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2342
Country : US
Telephone Number : 920-926-0101
Fax Number : 920-926-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 12/28/2021

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Directions to “ MS. KAY L CHRISTIANSON CSAC CLINICAL SUBSTA” Practice Location

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