Individual
THERESA A. BRUNER-LEYDENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4039 80TH ST, SUITE D, KENOSHA, WI 53142-4959
(262) 657-5026
(262) 657-5663
Mailing address
4039 80TH ST, SUITE D, KENOSHA, WI 53142-4959
(262) 657-5026
(262) 657-5663
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3187-125
WI
Other
Enumeration date
01/26/2010
Last updated
01/26/2010
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