Organization
LOCKE CONSULTING SERVICES COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLIE DEE LOCKE PH.D. (CHIEF EXECUTIVE OFFICER)
(708) 224-7442
Entity
Organization
Contact information
Practice address
9020 15TH AVE, KENOSHA, WI 53143-6803
(708) 224-7442
Mailing address
9020 15TH AVE, KENOSHA, WI 53143-6803
(708) 224-7442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40994300
—
WI
Enumeration date
03/11/2008
Last updated
03/11/2008
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