Individual
THERESA M KERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
405 E FOREST ST, OCONOMOWOC, WI 53066-3707
(262) 661-1759
Mailing address
405 E FOREST ST, OCONOMOWOC, WI 53066-3707
(262) 661-1759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10817-125
WI
Other
Enumeration date
08/04/2022
Last updated
01/17/2024
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