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Organization
UNMASKED EXPRESSIVE THERAPIES
Active
Organization
UNMASKED EXPRESSIVE THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI JOE DELISLE ATR-BC, LPC (EXECUTIVE DIRECTOR)
(920) 382-0445
Entity
Organization
Contact information
Practice address
207 N SPRING ST, BEAVER DAM, WI 53916-2115
(920) 219-9448
Mailing address
209 S UNIVERSITY AVE STE 1, BEAVER DAM, WI 53916-2464
(920) 219-9448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6745-125
WI
Other
Enumeration date
06/12/2018
Last updated
11/05/2024
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