Individual provider · Type 1 NPI

Kelly Thomack

Professional Counselor · Appleton, WI

NPI number 1750796488 Active

Practice location

5471 W Waterford Ln
Appleton, WI 54913-8510

Call (920) 731-7445 Map

Fax (920) 731-7490

Mailing address

1835 E Edgewood Dr Ste 105-540
Appleton, WI 54913-9407

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X5455-125 (WI)

Professional Counselor: Definition to come...

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About NPI 1750796488

Kelly Thomack's National Provider Identifier is 1750796488, issued on Jun 20, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Appleton, WI. The record was last updated on Jul 15, 2022.