Individual
MR. MARK ALAN WIERSCHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
319 MAIN ST., SUITE 302, LA CROSSE, WI 54601
(608) 796-1168
Mailing address
490 WAGON DR., WEST SALEM, WI 54669
(608) 786-4475
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3284-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40960900
—
WI
Enumeration date
05/01/2007
Last updated
07/08/2007
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