Individual
JACLYN MARIE BYKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
2733 S RIDGE RD, GREEN BAY, WI 54304-5513
(920) 497-6200
Mailing address
508 PEBBLESTONE CIR APT 95, HOBART, WI 54155-9317
(414) 232-5033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4374-226
WI
101YP2500X
Professional Counselor
Primary
4374-226
WI
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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