Individual
TERI MCDOUGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC, ICS
Contact information
Practice address
4647 MORMON COULEE RD, LA CROSSE, WI 54601-8225
(608) 519-3080
(608) 519-3083
Mailing address
4647 MORMON COULEE RD, LA CROSSE, WI 54601-8225
(608) 519-3080
(608) 519-3083
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12192-134
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
1540-132
WY
Other
Enumeration date
12/29/2006
Last updated
08/15/2012
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