Individual
PENNY LASALLE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
7251 W NORTH AVE, WAUWATOSA, WI 53213-1851
(414) 258-6000
(414) 258-3700
Mailing address
7251 W NORTH AVE, WAUWATOSA, WI 53213-1851
(414) 258-6000
(414) 258-3700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
653-226
WI
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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