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1154994382
JAMIE THEISEN
GREEN BAY, WI
NPI
1154994382
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 19237-130)
Enumeration Date
2021-07-24
Last Update Date
2021-07-24
Business Address
JAMIE THEISEN SAC-IT
2357 W MASON ST
GREEN BAY, WI 54303-4708
Phone number: 920-337-6740
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Mailing Address
JAMIE THEISEN SAC-IT
2357 W MASON ST
GREEN BAY, WI 54303-4708
Phone number: 920-337-6740
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