Provider Information for 1548542236
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MEGHAN RENEE COLE LPC, CSAC
Other Names:Former Name:MEGHAN RENEE MCDONALD LPC, CSACSex: Female
NPI: 1548542236
Last Updated: 2011-12-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1548542236 | ||||||||||||
| Enumeration Date | 2011-09-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1020 S MAIN ST FOND DU LAC, WI 54935-6138 United States Phone: 920-923-9054 | Fax:920-322-9193 | ||||||||||||
| Primary Practice Address | 1020 S MAIN ST FOND DU LAC, WI 54935-6138 United States Phone: 920-923-9054 | Fax:920-322-9193 | ||||||||||||
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