Most Relevant Information
Provider Data
| NPI Number: | 1003315334 |
| Provider Name: | NICOLE M. TESCH LPC-IT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 3788 |
Most Important Dates
| Enumeration Date: | 02/01/2018 |
| Last Updated: | 02/01/2018 |
Provider Practice Location
1100 LAKE VIEW DR
WAUSAU
WI
544036785
Practice Location Phone/Fax
| Phone: | 7158484600 |
| Fax: | 7158455398 |
Provider Mailing Location
1100 LAKE VIEW DR
WAUSAU
WI
544036785
Provider Mailing Phone/Fax
| Phone: | 7158484600 |
| Fax: | 7158455398 |