Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2187-226 | WI |
NPI | 1003221821 |
---|---|
Provider Name | Alicia S Skiles |
First Address | La Crosse, WI 54601-4200 |
Second Address | La Crosse, WI 54601-4200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 01/07/2014 |