Individual
MARY JACOBSON STELLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.E., ECSE
Contact information
Practice address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
(920) 749-5874
Mailing address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
169066
WI
Other
Enumeration date
01/12/2008
Last updated
01/12/2008
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