Individual
MARY KATHLEEN MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
Mailing address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4287226
WI
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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