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General NPI Number Information
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NPI Number | 1952731465
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Entity Type | Organization
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Legal Business Name | YOUR PLACE COUNSELING SERVICES
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 404 N MAIN ST SUITE 507
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City | OSHKOSH
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State | WI
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Zip | 54901-4957
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Country | US
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Telephone | 920-230-2363
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Fax |
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Provider Business Mailing Address
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Address Line | 404 N MAIN ST SUITE 507
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City | OSHKOSH
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State | WI
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Zip | 54901-4957
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Country | US
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Telephone | 920-230-2363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA EVA SCHMIDT
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Credential | LPC
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Telephone | 414-315-9323
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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 | 5077125
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License Number State | WI
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