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1841969151
MICAELLA MARIA VANDENBOOM
DE PERE, WI
NPI
1841969151
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Former Name
MICAELLA M SCHNEIDER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: WI 7857-125)
Enumeration Date
2021-09-09
Last Update Date
2021-09-09
Business Address
MICAELLA MARIA VANDENBOOM LPC
1325 ANGELS PATH
DE PERE, WI 54115-4050
Phone number: 920-338-2855
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Mailing Address
MICAELLA MARIA VANDENBOOM LPC
PO BOX 22040
GREEN BAY, WI 54305-2040
Phone number: 920-445-7222
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