Individual
JEFFREY W STACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 CHRISTOPHER CT, OCONOMOWOC, WI 53066-2321
(262) 567-1302
Mailing address
1200 CHRISTOPHER CT, OCONOMOWOC, WI 53066-2321
(262) 567-1302
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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