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Individual

MARY KAE HELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
920 60TH ST, KENOSHA, WI 53140-4041
(262) 654-5333
(262) 654-7818
Mailing address
920 60TH ST, KENOSHA, WI 53140-4041
(262) 654-5333
(262) 654-7818

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2238-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
234312
MANAGED HEALTH NETWORK
05
39603000
WI
01
82202
CHILDREN'S COMMUNITY HLTH
Enumeration date
02/06/2007
Last updated
07/08/2007
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