Individual
MARK A STAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSE, CADC, LPC
Contact information
Practice address
214 EAST SUMMER STREET, APPLETON, WI 54911
(920) 734-2601
(920) 727-1081
Mailing address
924 TAYCO STREET, MENASHA, WI 54952
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2967-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43566400
—
WI
Enumeration date
10/25/2006
Last updated
07/09/2007
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