Organization
TONI LIDDY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONETTE MARIE LIDDY M.S. LPC NCC (LICENSED PROFESSIONAL COUNSELOR)
(414) 429-6522
Entity
Organization
Contact information
Practice address
800 E LOCUST ST, MILWAUKEE, WI 53212-2634
(414) 429-6522
(414) 502-0192
Mailing address
2369 S 57TH ST, WEST ALLIS, WI 53219-2215
(414) 429-6522
(414) 502-0192
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
244-125
WI
101YP2500X
Professional Counselor
Primary
244-125
WI
104100000X
Social Worker
244-125
WI
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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