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Organization

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Active
Other names
N/A
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHIRLEY WORTHAM LPC (PROFESSIONAL COUNSELING)
(608) 436-1727
Entity
Organization

Contact information

Practice address
1203 SAINT LAWRENCE AVE, BELOIT, WI 53511-5067
(608) 436-1727
Mailing address
1203 SAINT LAWRENCE AVE, BELOIT, WI 53511-5067
(608) 436-1727

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2817226
WI

Other

Enumeration date
02/27/2016
Last updated
02/27/2016
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