Individual
KOREEN HOUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 652-2408
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 654-1004
(262) 654-6960
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2376-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43560800
—
WI
Enumeration date
01/04/2007
Last updated
06/30/2008
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