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General NPI Number Information
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NPI Number | 1972049740
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Entity Type | Individual
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Provider Name | MARTHA STOLP LPC
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Gender | Female
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 2004 HIGHLAND AVE SUITE 2N
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4400
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Country | US
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Telephone | 715-835-5915
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 8TH AVE
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City | BLOOMER
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State | WI
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Zip | 54724-1125
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Country | US
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Telephone | 715-497-4408
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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 | 3400-226
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7225-125
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License Number State | WI
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