MEDICARE: MS. JUDITH M RIBBENS M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	399-125	WI

General Provider Information

NPI Number	:	1245493352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH M RIBBENS M.A.

Provider Business Mailing Address
First Line	:	1557 CLEVELAND AVE
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143-3920
Country	:	US
Telephone Number	:	715-732-6868
Fax Number	:	715-732-6866

Provider Business Practice Location Address
First Line	:	1557 CLEVELAND AVE
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143
Country	:	US
Telephone Number	:	715-732-6868
Fax Number	:	715-732-6866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	12/10/2018

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