Organization
PATHWAY TO WELLNESS COMMUNITY CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY M KIRCH (OWNER)
(608) 643-3663
Entity
Organization
Contact information
Practice address
560 4TH ST, PRAIRIE DU SAC, WI 53578-1136
(608) 370-8131
(608) 643-5014
Mailing address
560 4TH ST, PRAIRIE DU SAC, WI 53578-1136
(608) 643-3663
(608) 370-8177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/26/2016
Last updated
12/12/2023
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