Provider Demographics
NPI:1881973345
Name:VONHAGKE, THEKLA MARGARET (LPC)
Entity type:Individual
Prefix:MS
First Name:THEKLA
Middle Name:MARGARET
Last Name:VONHAGKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11390
Mailing Address - Street 2:610 W. BROADWAY, SUITE L 1
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-1390
Mailing Address - Country:US
Mailing Address - Phone:307-733-3908
Mailing Address - Fax:307-733-0017
Practice Address - Street 1:610 W BROADWAY AVE
Practice Address - Street 2:SUITE L 1
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8213
Practice Address - Country:US
Practice Address - Phone:307-733-3908
Practice Address - Fax:307-733-0017
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC 408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health