Individual
KRISTEN L VESBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, ATR-L
Contact information
Practice address
2976 TRIVERTON PIKE DR, SUITE 119, FITCHBURG, WI 53711-5840
(262) 719-6569
(608) 286-1088
Mailing address
6692 FAIRWAY CIR, WINDSOR, WI 53598-9740
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
97-36
WI
101YP2500X
Professional Counselor
Primary
5219-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336416635
—
WI
Enumeration date
11/30/2011
Last updated
12/01/2015
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