Individual
MIKE KONIECZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1025 S MOORLAND RD, SUITE #407, BROOKFIELD, WI 53005-6956
(262) 789-7100
Mailing address
1025 S MOORLAND RD, SUITE #407, BROOKFIELD, WI 53005-6956
(262) 789-7100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4043-123
WI
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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