| Beautifully Broken Counseling Llc | |
|
1216 Maplewood Ct De Pere WI 54115-4232 | |
| (920) 334-0607 | |
| Not Available |
| Full Name | Beautifully Broken Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1216 Maplewood Ct, De Pere, Wisconsin |
| Authorized Official Name and Position | Amanda Radtke (OWNER) |
| Authorized Official Contact | 9203340607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautifully Broken Counseling Llc 1216 Maplewood Ct De Pere WI 54115-4232 Ph: () - | Beautifully Broken Counseling Llc 1216 Maplewood Ct De Pere WI 54115-4232 Ph: (920) 334-0607 |
| NPI Number | 1336889062 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336889062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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