Individual
BRIAN KEITH FALCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
N8809 BUS HWY 13, WESTBORO, WI 54490-9444
(920) 475-7668
Mailing address
N8809 BUS HWY 13, WESTBORO, WI 54490-9444
(920) 475-7668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1996-123
WI
Other
Enumeration date
12/29/2010
Last updated
08/20/2013
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