Individual
BENNETT F MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
2901 HUNTERS TRL, PORTAGE, WI 53901-3403
(608) 742-5518
(608) 268-9780
Mailing address
PO BOX 301, PORTAGE, WI 53901-0301
(608) 742-5518
(608) 268-9780
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8430
WI
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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