Individual
KATHLEEN PEROUTKA MARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13035 W BLUEMOUND RD STE 100, BROOKFIELD, WI 53005-8001
(262) 784-1121
(262) 784-9777
Mailing address
13035 W BLUEMOUND RD STE 100, BROOKFIELD, WI 53005-8001
(262) 784-1121
(262) 784-9777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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