Individual
SAMANTHA B KESTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
112 PEACE LUTHERAN PKWY, HARTFORD, WI 53027-1159
(800) 438-1772
(262) 293-9737
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-6511
(800) 438-1772
(262) 293-9737
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3741-226
WI
101YP2500X
Professional Counselor
Primary
8406-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073005
—
WI
Enumeration date
11/06/2017
Last updated
01/28/2022
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