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General NPI Number Information
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NPI Number | 1164546818
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Entity Type | Individual
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Provider Name | PATRICIA L. JINDRICH LPC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 6530 SHERIDAN RD SUITE 7
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City | KENOSHA
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State | WI
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Zip | 53143-5063
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Country | US
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Telephone | 262-857-8707
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Fax | 262-862-7703
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Provider Business Mailing Address
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Address Line | 6530 SHERIDAN RD SUITE 7
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City | KENOSHA
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State | WI
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Zip | 53143-5063
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Country | US
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Telephone | 262-857-8707
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Fax | 262-862-7703
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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 | 3493-125
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License Number State | WI
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