Individual
MARY THERESE JANSEN-KUBICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1751 N 73RD ST, WAUWATOSA, WI 53213-2214
(414) 940-5691
Mailing address
1751 N 73RD ST, WAUWATOSA, WI 53213-2214
(414) 940-5691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2521-123
WI
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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