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General NPI Number Information
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NPI Number | 1932340437
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Entity Type | Individual
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Provider Name | JOHN CLAUS MARXEN LPC
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Gender | Male
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 3126 W 20TH AVE
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City | OSHKOSH
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State | WI
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Zip | 54904-9258
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Country | US
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Telephone | 920-279-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 1736 BERNHEIM ST
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City | OSHKOSH
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State | WI
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Zip | 54904-8967
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Country | US
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Telephone | 920-279-6001
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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 | 3020-125
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License Number State | WI
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