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Individual

MRS. KRISTIN L MAINVILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
16535 W BLUEMOUND RD, SUITE 200, BROOKFIELD, WI 53005-5936
(262) 789-1191
Mailing address
14775 W MAYFLOWER DR, NEW BERLIN, WI 53151-6757
(414) 333-5096

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4010-125
WI

Other

Enumeration date
02/18/2008
Last updated
01/25/2009
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