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1043700115
ELAINE JEAN DOXTATOR
GREEN BAY, WI
NPI
1043700115
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 18545-130)
Enumeration Date
2018-05-15
Last Update Date
2018-05-15
Business Address
ELAINE JEAN DOXTATOR SAC-IT
1701 DOUSMAN ST
GREEN BAY, WI 54303-3211
Phone number: 920-593-5630
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Mailing Address
ELAINE JEAN DOXTATOR SAC-IT
1701 DOUSMAN ST
GREEN BAY, WI 54303-3211
Phone number: 920-593-5630
Copy
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