Individual
MRS. RENEE BIRKHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT, SAS
Contact information
Practice address
2901 HUNTERS TRL, PORTAGE, WI 53901-3403
(608) 742-5518
(608) 742-4087
Mailing address
1002 LINCOLN AVE, BARABOO, WI 53913-1808
(608) 356-9055
(608) 356-5447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2645-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467826990
—
WI
Enumeration date
11/20/2015
Last updated
02/01/2018
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