Individual
KHALIO BORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC-IT
Contact information
Practice address
4025 N 92ND ST, MILWAUKEE, WI 53222-1613
(414) 435-0333
Mailing address
PO BOX 1115, MENOMONEE FALLS, WI 53052-1115
(414) 435-0333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4681-226
WI
Other
Enumeration date
08/11/2020
Last updated
11/21/2022
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