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RUTH ALICE HOLMQUIST APSW CSAC CADCIII

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1851428528

Individual Registrant:
 RUTH ALICE HOLMQUIST APSW CSAC CADCIII
Gender: F
Not Sole Proprietor

Location and contact information for practice:
571 COUNTY RD A  GREEN LAKE, WI 54941-9798 US
Tel: 920-294-4070  Fax: 920-294-4139

Contact information for business:
PO BOX 588  GREEN LAKE, WI 54941-0588 US
Tel: 920-294-4070  Fax: 920-294-4139

Registration Information:
NPI: 1851428528
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
WI12971 132
N101YM0800XBehavioral Health & Social Service Providers
Counselor
WI356 121

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
40942000WI05




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