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Individual

MARY THERESE SOSALLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
4811 S 76TH ST # 305, GREENFIELD, WI 53220-4364
(414) 325-7741
Mailing address
4811 S 76TH ST # 305, GREENFIELD, WI 53220-4364
(414) 325-7741

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.011135
IL
101YM0800X
Mental Health Counselor
Primary
7323-125
WI

Other

Enumeration date
03/02/2017
Last updated
07/09/2019
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