Lake Geneva Wellness Clinic LLC
NPI #1003845181 in Lake Geneva, Wisconsin
Provider Information
- NPI Number
- 1003845181
- Entity Type
- Organization
- Organization Name
- Lake Geneva Wellness Clinic LLC
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Jul 1, 2006
- Last Updated
- Sep 12, 2024
Practice Location
- Address
- 750 VETERANS PKWY UNIT 100
- City
- Lake Geneva
- State
- Wisconsin
- ZIP Code
- 53147-4950
- Phone
- (262) 248-7942
Authorized Official
- Name
- ERIKA K FOUNTAIN, LPC W/AODA SPECIALTY
- Title
- OWNER
- Phone
- (262) 248-7942
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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