Individual
SHAQUITA GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
1845 N FARWELL AVE STE 301, MILWAUKEE, WI 53202-1715
(414) 223-3815
Mailing address
6528 W CENTER ST APT 4, MILWAUKEE, WI 53210-1392
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3434-226
WI
Other
Enumeration date
01/05/2019
Last updated
01/05/2019
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