| Mary B Riedel | |
|
115 5th Ave S Suite 301 La Crosse WI 54601-9200 | |
| (608) 799-1208 | |
| Not Available |
| Full Name | Mary B Riedel |
|---|---|
| Speciality | Counselor - Professional |
| Location | 115 5th Ave S, La Crosse, Wisconsin |
| Authorized Official Name and Position | Mary B Riedel (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 6087991208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary B Riedel 317 Grant St Holmen WI 54636-8614 Ph: (608) 799-1208 | Mary B Riedel 115 5th Ave S Suite 301 La Crosse WI 54601-9200 Ph: (608) 799-1208 |
| NPI Number | 1215356779 |
|---|---|
| Provider Enumeration Date | 04/14/2014 |
| Last Update Date | 04/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215356779 | NPI | - | NPPES |
| 100029060 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4671-125 (Wisconsin) | Primary |
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