Organization
BRIDGEPORT COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LLOYD PANULA LPC (LICENSED PROFESSIONAL COUNSELOR)
(715) 395-7825
Entity
Organization
Contact information
Practice address
2231 CATLIN AVE, ROOM #310, SUPERIOR, WI 54880-5137
(715) 395-7825
(715) 395-7826
Mailing address
2231 CATLIN AVE, ROOM #310, SUPERIOR, WI 54880-5137
(715) 395-7825
(715) 395-7826
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2837-125
WI
Other
Enumeration date
09/23/2008
Last updated
09/23/2008
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