| Doctor Name: | MS. CONSTANCE K VIRNIG |
| NPI Number: | 1174895809 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 4719-125 |
| Business Practice Address: | 420 1st Ave S Po 1535 Wisconsin Rapids, WI - 544954157 |
| Business Phone Number: | 7154243400 |
| Business Fax Number: | 7154243441 |
| Mailing Address: | 420 1st Ave. South, Po 1535 WISCONSIN RAPIDS |
| State: | WI |
| Postal Code: | 544951535 |
| Phone Number: | 7154243400 |
| Fax Number: | 7154243441 |
| NPI Enumeration Date: | 01/26/2012 |
| NPI Last Update Date: | 01/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4719-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |