Individual
HEATHER KEKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Mailing address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19464
WI
1041C0700X
Clinical Social Worker
Primary
131833-121
WI
Other
Enumeration date
08/26/2022
Last updated
09/20/2022
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