| Doctor Name: | MS. AMY CLAIRE WILLETTE |
| NPI Number: | 1285687483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MS, CADC, LCSW |
| License Number: | 12563 |
| Business Practice Address: | 517 Court St Room 503 Neillsville, WI - 544561971 |
| Business Phone Number: | 7157435204 |
| Business Fax Number: | 7157435209 |
| Mailing Address: | 703 Rose St, BLACK RIVER FALLS |
| State: | WI |
| Postal Code: | 546159201 |
| Phone Number: | 7152844058 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 12563 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |