Individual
MELISSA HACKBARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
405 E FOREST ST, OCONOMOWOC, WI 53066-3707
(920) 428-3379
Mailing address
405 E FOREST ST STE 117, OCONOMOWOC, WI 53066-3707
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11378-125
WI
101YM0800X
Mental Health Counselor
5350-226
WI
Other
Enumeration date
08/17/2022
Last updated
10/27/2024
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