Individual
MARK DANIEL DITTLOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 834-8833
(920) 834-8830
Mailing address
PO BOX 1866, GREEN BAY, WI 54305-1866
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
64969
TX
101YP2500X
Professional Counselor
Primary
8608-125
WI
Other
Enumeration date
02/24/2009
Last updated
11/11/2022
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