Individual
JACQUELYN M TOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1910 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15453
WI
101YP2500X
Professional Counselor
Primary
6401
WI
Other
Enumeration date
07/06/2010
Last updated
01/03/2024
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