Individual
LAURIE RAE REISENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
3703 N MURRAY AVE, SHOREWOOD, WI 53211-2554
(414) 698-7776
Mailing address
3703 N MURRAY AVE, SHOREWOOD, WI 53211-2554
(414) 698-7776
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8106-226
WI
101YP2500X
Professional Counselor
8106-226
WI
Other
Enumeration date
09/10/2024
Last updated
10/07/2024
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