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Individual

MICHAELLA BRICKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
705 S 24TH AVE STE 400, WAUSAU, WI 54401-5242
(715) 848-1457
(715) 848-2959
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4432-226
WI
101YP2500X
Professional Counselor
4432-226
WI
101YP2500X
Professional Counselor
Primary
8409-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629698378
WI
Enumeration date
04/23/2020
Last updated
01/11/2022
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