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Individual

JASON W TRAXEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
121 W MAIN ST, PORT WASHINGTON, WI 53074-1813
(262) 284-8200
(262) 284-8104
Mailing address
121 W MAIN ST, PORT WASHINGTON, WI 53074-1813
(262) 284-8200
(262) 284-8104

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
127011-121
WI
1041C0700X
Clinical Social Worker
Primary
7591-123
WI

Other

Enumeration date
11/14/2006
Last updated
03/12/2015
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