Individual
TANYA MARIE WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATR, LPC
Contact information
Practice address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 338-2717
(262) 338-9767
Mailing address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 338-2717
(262) 338-9767
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4507-125
WI
221700000X
Art Therapist
103-036
WI
Other
Enumeration date
02/07/2011
Last updated
02/15/2011
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