Individual provider · Type 1 NPI
Mark Daniel Dittloff, MS, LPC
Professional Counselor · Oconto, WI
NPI number
1194965590
Active
Practice location
820 Arbutus Ave
Oconto, WI 54153-2004
Fax (920) 834-8830
Mailing address
PO Box 1866
Green Bay, WI 54305-1866
Other practice locations
- 1512 Scripture St, Denton, TX 76201-3916 · (940) 382-5328
- 301 E Saint Joseph St, Green Bay, WI 54301-2241 · (920) 433-3630
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | 64969 (TX) |
| Professional Counselor Primary | 101YP2500X | 8608-125 (WI) |
Professional Counselor: Definition to come...
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About NPI 1194965590
Mark Daniel Dittloff, MS, LPC's National Provider Identifier is 1194965590, issued on Feb 24, 2009. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Oconto, WI. The record was last updated on Nov 11, 2022.