| Panou Lee, | |
|
620 W Brown St, Waupun, WI 53963-1702 | |
| (920) 324-7600 | |
| Not Available |
| Full Name | Panou Lee |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 620 W Brown St, Waupun, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891421392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Entity Name | Agnesian Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Panou Lee, 620 W Brown St, Waupun, WI 53963-1702 Ph: Not Available | Panou Lee, 620 W Brown St, Waupun, WI 53963-1702 Ph: (920) 324-7600 |
Kourtney Kaye Lechner Ullrich, MS LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 W Brown St, Waupun, WI 53963 Phone: 920-926-4200 |
Kamelah Reed, Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 S Madison St, Waupun, WI 53963 Phone: 414-301-1741 |
Hannah Domasky, LPC-IT Counselor Medicare: Accepting Medicare Assignments Practice Location: 620 W Brown St, Waupun, WI 53963 Phone: 920-324-5581 |
Megan Hoag, Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 W Brown St, Waupun, WI 53963 Phone: 920-324-7600 |
Alyssa A Hallgren, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 W Brown St, Waupun, WI 53963 Phone: 920-926-4200 |