Individual
MRS. JENNIFER LYNN BURELBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSA
Contact information
Practice address
2920 EAST AVE S STE 101, LA CROSSE, WI 54601-8282
(608) 397-8727
Mailing address
2920 EAST AVE S STE 101, LA CROSSE, WI 54601-8282
(608) 397-8727
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6890123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376343
TRICARE CHAMPUS
WI
05
—
40939800
—
WI
Enumeration date
09/29/2006
Last updated
03/17/2018
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