Individual
BRENDA JANE ERTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
420 3RD ST S, WISCONSIN RAPIDS, WI 54494-4350
(715) 712-1370
Mailing address
PO BOX 633, PLOVER, WI 54467-0633
(608) 403-8839
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
101356-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101179
—
WI
Enumeration date
04/30/2020
Last updated
08/27/2023
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