Individual
BROOKE T KYSELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(206) 741-1349
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 318-2095
(920) 887-3977
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4834226
WI
101YP2500X
Professional Counselor
Primary
8573-125
WI
Other
Enumeration date
02/11/2021
Last updated
01/29/2023
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