Individual
KEELA COPPERSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
Mailing address
631 FOREST ST, WAUSAU, WI 54403-5524
(414) 526-3592
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4553-226
WI
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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