Individual
MARISSA A MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 TRI PARK WAY BLDG 2, APPLETON, WI 54914-6445
(920) 809-4125
Mailing address
5154 JUNIPER LN, OSHKOSH, WI 54904-9702
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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