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Individual

KELLY A DUBORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2323 N LAKE DR FL 1, MILWAUKEE, WI 53211-4508
(414) 585-6120
Mailing address
2323 N LAKE DR FL 1, MILWAUKEE, WI 53211-4508
(414) 585-6120

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3633-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41008600
WI
Enumeration date
09/25/2006
Last updated
10/04/2023
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