Ertl, Brenda Jane

Ertl, Brenda Jane is an individual health care provider with primary practice located at 420 3Rd St S , Wisconsin Rapids WI 54494-4350. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Ertl, Brenda Jane can be contacted via phone (715) 712-1370.

Contact Information

Primary practice address
420 3Rd St S Wisconsin Rapids WI 54494-4350
Phone: (715) 712-1370
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 101356-125 Wisconsin

Profile Details

NPI number 1598386583
LBN Legal business name Ertl, Brenda Jane
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2020
Last updated Aug 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598386583 NPPES
Wisconsin MEDICAID 100101179

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