Individual
LINDA MCCLENAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
6929 MARINER DR, RACINE, WI 53406-3938
(414) 571-9484
(414) 571-9648
Mailing address
5635 ERIE ST, RACINE, WI 53402-1934
(414) 571-9484
(414) 571-9648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3181-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40935800
—
WI
Enumeration date
04/10/2007
Last updated
07/08/2007
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