Individual
ALYSA COLLEEN ECKELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 MEDBURY ST, KENDALL, WI 54638-8632
(608) 343-9640
Mailing address
601 MEDBURY ST, KENDALL, WI 54638-8632
(608) 343-9640
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1204953
WI
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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