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Individual

MRS. LORI LEE LANDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, SAC

Contact information

Practice address
W156N8327 PILGRIM RD, 302, MENOMONEE FALLS, WI 53051-3776
(262) 251-1112
(262) 251-1113
Mailing address
N173W19997 CREEKSIDE DR, JACKSON, WI 53037-9107
(262) 442-2107

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14104-131
WI
1041C0700X
Clinical Social Worker
Primary
6734-123
WI

Other

Enumeration date
10/23/2009
Last updated
10/23/2009
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