Individual
MS. DEIDRE RACHEL PROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2510 E CAPITOL DR, SHOREWOOD, WI 53211-2136
(262) 957-6311
Mailing address
1916 E ELMDALE CT, SHOREWOOD, WI 53211-2342
(262) 957-6310
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7349
WI
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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