Individual
MR. GLENN ALAN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,NCC,LPC-IT,SAC-IT
Contact information
Practice address
6040 W LISBON AVE STE 102, MILWAUKEE, WI 53210-2116
(414) 871-9111
Mailing address
6040 W LISBON AVE STE 102, MILWAUKEE, WI 53210-2116
(414) 871-9111
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
621-226
WI
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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