KELLIE JEAN DIELS

FOND DU LAC, WI
NPI1265065957
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  19064-130)
Enumeration Date2020-02-20
Last Update Date2024-07-19
Business Address
KELLIE JEAN DIELS SAC-IT
459 E 1ST ST
FOND DU LAC, WI 54935-4505
Phone number: 920-920-3568
Mailing Address
KELLIE JEAN DIELS SAC-IT
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number:
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