Organization
GTN FENNIMORE, INC.
Active
Other names
Southwest Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA ANN TROLLOP LCSW (OWNER)
(608) 778-6978
Entity
Organization
Contact information
Practice address
1160 LINCOLN AVE, FENNIMORE, WI 53809-1746
(608) 822-5052
(608) 822-0131
Mailing address
1160 LINCOLN AVE, FENNIMORE, WI 53809-1746
(608) 822-5052
(608) 822-0131
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
384
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39613700
—
WI
Enumeration date
06/25/2014
Last updated
09/30/2020
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