Individual
MACARENA CORREA VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1205 S 70TH ST, STE 301, WEST ALLIS, WI 53214-4454
(414) 475-2788
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 652-1004
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
7296-226
WI
101YP2500X
Professional Counselor
Primary
11472-125
WI
Other
Enumeration date
03/06/2023
Last updated
01/07/2025
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