Individual
MRS. KRYSTAL A CONKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
32 S MAIN ST, JANESVILLE, WI 53545-3941
(608) 618-5560
Mailing address
32 S MAIN ST, JANESVILLE, WI 53545-3941
(608) 728-0957
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
130523-121
WI
1041C0700X
Clinical Social Worker
Primary
9087-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9087-123
MENTAL HEALTH
WI
Enumeration date
02/06/2017
Last updated
10/16/2023
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