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Organization

DRIFTLESS COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRIS RUDER LMFT (DIRECTOR)
(608) 606-6789
Entity
Organization

Contact information

Practice address
118 E JEFFERSON ST, VIROQUA, WI 54665-1613
(608) 606-6789
Mailing address
247 5TH AVE, VIROQUA, WI 54665-1815
(608) 606-6789

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
Primary
225800000X
Recreation Therapist
225C00000X
Rehabilitation Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285029280
WI
05
1316486731
WI
Enumeration date
02/11/2020
Last updated
02/11/2020
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