Individual
ANTHONY PENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-IT
Contact information
Practice address
17 FOREST AVE STE 15, FOND DU LAC, WI 54935-4165
(920) 933-9256
Mailing address
17 FOREST AVE STE 15, FOND DU LAC, WI 54935-4165
(920) 933-9256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5024-226
WI
101YP2500X
Professional Counselor
Primary
10222-125
WI
Other
Enumeration date
01/27/2022
Last updated
02/09/2023
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