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1093281370
TORY PHONSAVAN KOETTERHAGEN
WAUKESHA, WI
NPI
1093281370
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 8075-123)
Enumeration Date
2018-10-15
Last Update Date
2018-10-15
Business Address
Mrs. TORY PHONSAVAN KOETTERHAGEN LCSW
W236S4564 WHISPERING HILLS CT
WAUKESHA, WI 53189-9772
Phone number: 414-467-6994
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Mailing Address
Mrs. TORY PHONSAVAN KOETTERHAGEN LCSW
W236S4564 WHISPERING HILLS CT
WAUKESHA, WI 53189-9772
Phone number: 414-467-6994
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