Individual
JAMES TARY KIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., LPC
Contact information
Practice address
2733 S RIDGE RD, GREEN BAY, WI 54304-5513
(920) 497-6200
Mailing address
4469 WYANDOT TRL, HOBART, WI 54313-6789
(920) 490-0991
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3373-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3373-125
LPC
WI
05
—
40952000
—
WI
Enumeration date
11/01/2006
Last updated
07/09/2007
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