Individual
MRS. HEATHER LYNN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
121 W MAIN ST, PORT WASHINGTON, WI 53074-1813
(262) 284-8229
(262) 284-8104
Mailing address
121 W MAIN ST, P.O. BOX 994, PORT WASHINGTON, WI 53074-1813
(262) 284-8229
(262) 284-8104
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3765-125
WI
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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