Individual
MRS. DEBORAH J KLECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MFT-IT, SAC-IT
Contact information
Practice address
970 S SILVER LAKE ST, SUITE #103, OCONOMOWOC, WI 53066-3802
(262) 567-7377
(262) 567-7377
Mailing address
W6269 TRAIN RD, WATERTOWN, WI 53098-3909
(262) 893-7870
(262) 567-7377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15898-130
WI
101YP2500X
Professional Counselor
Primary
4958-125
WI
106H00000X
Marriage & Family Therapist
178-228
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255675112
—
WI
Enumeration date
11/15/2012
Last updated
11/29/2013
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