| Miranda Babl LLC | |
|
5303 E Jelinek Ave Weston WI 54476-4230 | |
| (715) 574-9628 | |
| Not Available |
| Full Name | Miranda Babl LLC |
|---|---|
| Speciality | Counselor |
| Location | 5303 E Jelinek Ave, Weston, Wisconsin |
| Authorized Official Name and Position | Miranda Tina Martha Babl (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7155749628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miranda Babl LLC 1762 Mcaddoe Pl Kronenwetter WI 54455-8109 Ph: (715) 574-9628 | Miranda Babl LLC 5303 E Jelinek Ave Weston WI 54476-4230 Ph: (715) 574-9628 |
| NPI Number | 1417837717 |
|---|---|
| Provider Enumeration Date | 09/05/2025 |
| Last Update Date | 09/05/2025 |
| Certification Date | 09/05/2025 |
| Medicare PECOS PAC ID | 2860989233 |
|---|---|
| Medicare Enrollment ID | O20251017002893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417837717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
| Provider Name | Miranda Babl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639688492 PECOS PAC ID: 3971954694 Enrollment ID: I20240108000814 |
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