Individual
LISA HERGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CLINICAL THERAPIS
Contact information
Practice address
252 S CENTRAL AVE, SUITE #21, MARSHFIELD, WI 54449-2843
(715) 384-7579
Mailing address
PO BOX 887, MARSHFIELD, WI 54449-0887
(715) 384-7579
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3557
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39672800
—
WI
05
—
42245000
—
WI
Enumeration date
11/14/2006
Last updated
07/09/2007
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