Individual
MRS. MARINNA MIL MAROTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC LCPC CSAC PMH-C
Contact information
Practice address
209 OCONNOR DR, ELKHORN, WI 53121-4269
(262) 374-5251
Mailing address
209 OCONNOR DR, ELKHORN, WI 53121-4269
(262) 374-5251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16192131
WI
101YP2500X
Professional Counselor
180.011635
IL
101YP2500X
Professional Counselor
Primary
6576125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.011635
LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
01
—
6576-125
LICENSED PROFESSIONAL COUNSELOR
WI
Enumeration date
09/26/2017
Last updated
07/28/2021
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