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1740538503
LISA H MICHNO
MENASHA, WI
NPI
1740538503
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Former Name
LISA M HACKER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16101)
Enumeration Date
2012-08-27
Last Update Date
2019-10-31
Business Address
LISA H MICHNO MA, SACT
1095 MIDWAY RD
MENASHA, WI 54952-1115
Phone number: 920-720-2300
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Mailing Address
LISA H MICHNO MA, SACT
122 E COLLEGE AVE
APPLETON, WI 54911-5794
Phone number: 920-996-3264
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