Individual
THERESA N OTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10117 74TH ST, SUITE 100, KENOSHA, WI 53142-7533
(262) 697-8268
Mailing address
7252 91ST AVE, KENOSHA, WI 53142-8253
(502) 412-4564
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5157-125
WI
101YP2500X
Professional Counselor
KY-1567
KY
Other
Enumeration date
01/10/2012
Last updated
08/31/2013
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