Nicole Shannon Thull, SAC-IT

NPI #1669962825 in Kewaskum, Wisconsin

Provider Information

NPI Number
1669962825
Entity Type
Individual
Name
Nicole Shannon Thull, SAC-IT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
SAC-IT
Enumeration Date
May 14, 2018
Last Updated
May 14, 2018

Practice Location

Address
1421 FOND DU LAC AVE
ZIP Code
53040-9136
Phone
(262) 626-4166

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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