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Individual

PATRICK MICHAEL TENNY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
50 PRAIRIE AVE, PRAIRIE DU SAC, WI 53578-1541
(608) 643-3147
(608) 647-3178
Mailing address
PO BOX 301, PORTAGE, WI 53901-0301
(608) 742-5518
(608) 742-4087

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
785-228
WI
106H00000X
Marriage & Family Therapist
Primary
785
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1730759838
WI
Enumeration date
06/30/2021
Last updated
11/28/2022
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