Individual
TERRI LEE WALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SACIT
Contact information
Practice address
5735 DURAND AVE, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
(262) 598-1395
Mailing address
5735 DURAND AVE, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
(262) 598-1395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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