Healthcare Provider Details

I. General information

NPI: 1124750773
Provider Name (Legal Business Name): LILLIAN HELENEA SCHIERBROCK MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 HERITAGE BLVD
WEST SALEM WI
54669-9404
US

IV. Provider business mailing address

315 3RD ST S APT 421
LA CROSSE WI
54601-4061
US

V. Phone/Fax

Practice location:
  • Phone: 608-799-4860
  • Fax:
Mailing address:
  • Phone: 319-470-5834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number17334
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: