Individual
MRS. SHIRLEY WORTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N3152 STATE ROAD 81, MONROE, WI 53566-9397
(608) 328-9393
(608) 328-9480
Mailing address
N3152 STATE ROAD 81, MONROE, WI 53566-9397
(608) 328-9393
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
281728
WI
101YP2500X
Professional Counselor
Primary
2817-226
WI
Other
Enumeration date
03/24/2017
Last updated
07/26/2024
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