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Individual

AUDRA-JANE TWIDWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
11121 W OKLAHOMA AVE, WEST ALLIS, WI 53227-4033
(262) 754-5912
Mailing address
2625 N 70TH ST, WAUWATOSA, WI 53213-1325

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7013
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/07/2020
Last updated
07/29/2025
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