Individual
MICHELLE R WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
1509 N 4TH ST, SUITE 2, TOMAHAWK, WI 54487-2142
(800) 236-3792
(715) 845-6477
Mailing address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
(715) 845-6477
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1497-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235579053
—
WI
Enumeration date
06/25/2013
Last updated
09/09/2014
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