Phoenix Rising LLC
NPI #1356794788 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1356794788
- Entity Type
- Organization
- Organization Name
- Phoenix Rising LLC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Jul 20, 2016
- Last Updated
- Apr 7, 2017
Practice Location
- Address
- N7640 COUNTY ROAD WH STE 200
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54937-7832
- Phone
- (920) 933-3736
Authorized Official
- Name
- CHRYSTAL STEPHANY, MA,LPC
- Title
- OWNER
- Phone
- (920) 251-4214
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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