Individual
COLEEN RAE KITTLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
12970 W BLUEMOUND RD, 308, ELM GROVE, WI 53122-2607
(262) 780-1020
(262) 780-1022
Mailing address
12970 W BLUEMOUND RD STE 200, ELM GROVE, WI 53122-2607
(262) 780-1020
(262) 780-1022
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1407-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10001649
—
WI
Enumeration date
01/09/2009
Last updated
02/05/2019
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