Individual
KJIRSTYN LEE WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
44 GOOD COUNSEL DR, MANKATO, MN 56001-6599
(800) 438-1772
(262) 345-5562
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-6511
(800) 438-1772
(262) 293-9737
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
01933
MN
101YP2500X
Professional Counselor
Primary
2014
MN
Other
Enumeration date
12/15/2016
Last updated
02/27/2020
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