Individual
THERESA A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS., LPC-T
Contact information
Practice address
4539 WOODGATE DR STE D, JANESVILLE, WI 53546-8205
(818) 208-4774
Mailing address
4539 WOODGATE DR STE D, JANESVILLE, WI 53546-8205
(818) 208-4774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5662-125
WI
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/30/2013
Last updated
03/10/2026
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