Individual
MARY JEAN MATEJCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-2396
(262) 544-1213
Mailing address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-2396
(262) 544-1213
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1943
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39387000
—
WI
Enumeration date
12/26/2006
Last updated
07/08/2007
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