NPI 1356681308

Miranda Marie Fassbender

Practitioner Professional Counselor Amery, WI

Practice location

Address: 230 Deronda St, Amery, WI 54001-1412
Phone: (715) 268-8000
Mailing address: 2265 Como Ave, Saint Paul, MN 55108-1737

Registered specialties (2)

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 5640.125 (WI)

Other Counselor providers in Wisconsin →

Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 1887 (MN)

Registry record

NPI: 1356681308
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Feb 2013
Record last updated: 11 Feb 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.