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Individual

MARDY JUHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 970-6672
Mailing address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 970-6672

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15486
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15743
WI

Other

Enumeration date
06/25/2020
Last updated
06/25/2020
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