Healthcare Provider Details

I. General information

NPI: 1073425229
Provider Name (Legal Business Name): VICTORIA MICHALSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 TIGER LN
BLACK RIVER FALLS WI
54615-1209
US

IV. Provider business mailing address

220 N 5TH ST
BLACK RIVER FALLS WI
54615-1236
US

V. Phone/Fax

Practice location:
  • Phone: 715-670-1427
  • Fax:
Mailing address:
  • Phone: 715-670-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number130224121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: