Individual
JEREMY J BURTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
602 PLEASANT OAK DRIVE, OREGON, WI 53575-3648
(608) 835-5050
(608) 835-5010
Mailing address
602 PLEASANT OAK DR, OREGON, WI 53575-3648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3249125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3249125
LICENSED PROF COUNSELOR
WI
05
—
40942700
—
WI
Enumeration date
11/03/2006
Last updated
07/08/2007
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