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Individual

JOSEPH LOUIS BODO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC,CSAC,ICS

Contact information

Practice address
171 CHESTNUT ST, PHILLIPS, WI 54555-1313
(715) 339-3048
Mailing address
N7368 UNIVERSAL DR, WINTER, WI 54896-7635
(715) 266-2400

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3232-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39380000
WI
Enumeration date
02/12/2007
Last updated
07/08/2007
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