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1699933036
THERESA DEWALT
RACINE, WI
NPI
1699933036
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: WI 3369-125)
Enumeration Date
2008-05-31
Last Update Date
2008-05-31
Business Address
-- THERESA DEWALT
1220 MOUND AVE STE 304
RACINE, WI 53404-3350
Phone number: 262-488-0011
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Mailing Address
-- THERESA DEWALT
1220 MOUND AVE STE 304
RACINE, WI 53404-3350
Phone number: 262-488-0011
Copy
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