N/a

NPI #1871953216 in Beloit, Wisconsin

Provider Information

NPI Number
1871953216
Entity Type
Organization
Organization Name
N/a
Primary Specialty
Community/Behavioral Health
Enumeration Date
Feb 27, 2016
Last Updated
Feb 27, 2016

Practice Location

Address
1203 SAINT LAWRENCE AVE
City
Beloit
ZIP Code
53511-5067
Phone
(608) 436-1727

Authorized Official

Name
MRS. SHIRLEY WORTHAM, LPC
Title
PROFESSIONAL COUNSELING
Phone
(608) 436-1727

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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