Individual
MARISSA A GAEDTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
(262) 789-1191
Mailing address
1501 AIRPORT RD, WAUKESHA, WI 53188-2461
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10856-125
WI
Other
Enumeration date
06/29/2023
Last updated
02/21/2024
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