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Individual

MRS. THERESA MARIE SHUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,MA,LCGC,LPC

Contact information

Practice address
15300 WATERTOWN PLANK RD #106, ELM GROVE, WI 53122-7503
(414) 807-8934
Mailing address
2112 ANDY JOHN CT, GREEN BAY, WI 54311-6371
(920) 606-0130

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
WI
170300000X
Genetic Counselor (M.S.)
WI

Other

Enumeration date
01/04/2006
Last updated
05/07/2023
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