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Individual

CHARITY WALSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-IT

Contact information

Practice address
1205 S 70TH ST, STE 301, WEST ALLIS, WI 53214
(414) 475-2788
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 654-1004

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7121
WI

Other

Enumeration date
10/04/2022
Last updated
06/05/2023
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