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General NPI Number Information
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NPI Number | 1063088045
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Entity Type | Individual
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Provider Name | JESSICA PLISZKA M.S., NCC, LPC-IT
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Gender | Female
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 10425 W NORTH AVE STE 312
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City | WAUWATOSA
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State | WI
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Zip | 53226-2416
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Country | US
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Telephone | 414-248-0064
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Fax |
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Provider Business Mailing Address
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Address Line | S81W17620 BRENNAN DR
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City | MUSKEGO
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State | WI
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Zip | 53150-8028
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Country | US
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Telephone | 414-403-5092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4969226
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License Number State | WI
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