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Individual

MR. MARK HUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
1051 NANTUCKET DR, JANESVILLE, WI 53546-1763
(608) 752-5335
Mailing address
3506 N US HIGHWAY 51, JANESVILLE, WI 53545-0726
(608) 757-5215

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2519-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1137-125
LPC
WI
01
2519-123
CLINICAL SOCIAL WORKER
WI
Enumeration date
03/15/2007
Last updated
07/08/2007
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