Individual
JESSICA ECKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7247
Mailing address
W330S4010 CONNEMARA DR, DOUSMAN, WI 53118-9798
(414) 807-2240
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
128065-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128065-212
STATE OF WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
08/25/2015
Last updated
08/25/2015
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