Individual
TINA MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3579 SIGGELKOW RD, MC FARLAND, WI 53558-9646
(608) 838-8999
Mailing address
2672 NORWICH ST, FITCHBURG, WI 53711-5456
(715) 919-0832
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
125-3308
WI
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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