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Individual

ALEXANDER JESKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2424 S 90TH ST, WEST ALLIS, WI 53227-2455
(414) 773-4312
(414) 329-5637
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5739
WI
101YP2500X
Professional Counselor
5739-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100245738
WI
Enumeration date
08/07/2015
Last updated
07/09/2024
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