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General NPI Number Information
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NPI Number | 1437677051
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Entity Type | Individual
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Provider Name | ALICIA MARIE GERSTNER LPC
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Gender | Female
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Dates
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Enumeration Date | 09/04/2017
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 3431 COMMODITY LN
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City | GREEN BAY
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State | WI
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Zip | 54304-5688
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Country | US
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Telephone | 800-222-8590
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Fax |
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Provider Business Mailing Address
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Address Line | 128 ALVINA ST APT 2
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City | GREEN BAY
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State | WI
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Zip | 54303-2444
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Country | US
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Telephone | 906-280-1990
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10518-125
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License Number State | WI
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