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1205525904
MELISSA A DETRIE
GREEN BAY, WI
NPI
1205525904
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: WI 7603-226)
Enumeration Date
2023-05-08
Last Update Date
2024-07-09
Business Address
MELISSA A DETRIE LPC-IT
2640 W POINT RD
GREEN BAY, WI 54304-1344
Phone number: 920-490-3875
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Mailing Address
MELISSA A DETRIE LPC-IT
PO BOX 365
ONEIDA, WI 54155-0365
Phone number: 920-490-3790
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