Individual
MR. MARK ALAN TEGTMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCSW, LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1863-125
WI
1041C0700X
Clinical Social Worker
Primary
2364-123
WI
106H00000X
Marriage & Family Therapist
479-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39273400
—
WI
Enumeration date
04/30/2008
Last updated
04/30/2008
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