Organization
KETTLE MORAINE COUNSELING LLC
Active
Other names
Kettle Moraine Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DEVONA LYNN MARSHALL MS LPC NCC (OWNER/DIRECTOR)
(262) 334-4340
Entity
Organization
Contact information
Practice address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 334-4340
(262) 334-4341
Mailing address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 334-4340
(262) 334-4341
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
3514-125
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/24/2009
Last updated
01/14/2020
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