Individual provider · Type 1 NPI

Kellie Jean Diels, SAC-IT

Addiction (Substance Use Disorder) Counselor · Fond Du Lac, WI

NPI number 1265065957 Active

Practice location

459 E 1st St
Fond Du Lac, WI 54935-4505

Call (920) 920-3568 Map

Mailing address

430 E Division St
Fond Du Lac, WI 54935-4560

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X19064-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1265065957

Kellie Jean Diels, SAC-IT's National Provider Identifier is 1265065957, issued on Feb 20, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fond Du Lac, WI. The record was last updated on Jul 19, 2024.