Individual
JACKIE K. RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
212 11TH ST S, LA CROSSE, WI 54601-4116
(608) 392-9555
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-3635
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15750
WI
101YM0800X
Mental Health Counselor
Primary
5179
WI
101YP2500X
Professional Counselor
5179
WI
Other
Enumeration date
05/30/2012
Last updated
12/27/2023
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