Individual
EDWARD JOSEPH JEDLICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
40 CAMELOT DR, FOND DU LAC, WI 54935-8049
(920) 907-8201
(920) 907-8209
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(209) 926-8343
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2239-125
WI
Other
Enumeration date
10/11/2011
Last updated
03/09/2023
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