Individual
NICOLE R WENDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
414 DOCTORS CT, OSHKOSH, WI 54901-2065
(920) 303-5100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 303-5100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3196
WI
101YP2500X
Professional Counselor
3196-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100061418
—
WI
Enumeration date
10/12/2016
Last updated
02/17/2025
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