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1346397122
TARA NOTZKE
MENASHA, WI
NPI
1346397122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 14008)
Enumeration Date
2007-01-04
Last Update Date
2007-07-08
Business Address
-- TARA NOTZKE
1095 MIDWAY RD
MENASHA, WI 54952-1115
Phone number: 920-720-2300
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Mailing Address
-- TARA NOTZKE
PO BOX 8003
APPLETON, WI 54912-8003
Phone number: 920-996-3298
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