Individual
KIRSTEN ELISE SELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT, SAC-IT
Contact information
Practice address
724 ELM ST, WEST BEND, WI 53095-3205
(262) 353-9701
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 654-1004
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5074
WI
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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