Individual
MR. CARL TYRONE KOELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., LPC
Contact information
Practice address
1220 MOUND AVE, STE 301, RACINE, WI 53404-3350
(262) 633-3591
(262) 633-2619
Mailing address
3008 INDIAN TRL, RACINE, WI 53402-1138
(414) 530-1441
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
831-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43718600
—
WI
Enumeration date
08/01/2007
Last updated
08/01/2007
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