Individual
MS. THERESA JOY DITLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
128 E OLIN AVE, MADISON, WI 53713
(608) 252-1333
Mailing address
128 E. OLIN, MADISON, WI 53713-1569
(608) 252-1333
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5019-125
WI
Other
Enumeration date
10/01/2013
Last updated
07/17/2018
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