Mary B Riedel | |
115 5th Ave S Suite 301 La Crosse WI 54601-9200 | |
(608) 799-1208 | |
Not Available |
Full Name | Mary B Riedel |
---|---|
Speciality | Counselor - Professional |
Location | 115 5th Ave S, La Crosse, Wisconsin |
Authorized Official Name and Position | Mary B Riedel (LICENSED PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 6087991208 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mary B Riedel 317 Grant St Holmen WI 54636-8614 Ph: (608) 799-1208 | Mary B Riedel 115 5th Ave S Suite 301 La Crosse WI 54601-9200 Ph: (608) 799-1208 |
NPI Number | 1215356779 |
---|---|
Provider Enumeration Date | 04/14/2014 |
Last Update Date | 04/14/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215356779 | NPI | - | NPPES |
100029060 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 4671-125 (Wisconsin) | Primary |
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