LEEANN GAUSE JACKSON

ELKHORN, WI
NPI1790270049
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: WI  7126-125)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16281-131)
101YP2500X Counselor, Professional
(Licence: IL  178009221)
221700000X Art Therapist
(Licence: WI  121-36)
Enumeration Date2018-06-28
Last Update Date2023-03-13
Business Address
LEEANN GAUSE JACKSON ATR
1910 COUNTY ROAD NN
ELKHORN, WI 53121-4454
Phone number: 262-741-3200
Mailing Address
LEEANN GAUSE JACKSON ATR
PO BOX 1005
ELKHORN, WI 53121-1005
Phone number: