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Individual

DIANE KNOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1622 CHESTNUT ST, WEST BEND, WI 53095-3014
(262) 338-9498
(262) 338-9506
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3412-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40984800
WI
Enumeration date
08/01/2006
Last updated
01/04/2008
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