Individual
NATHANIEL WILLKOMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 652-2408
Mailing address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 652-2408
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4434-226
WI
101YP2500X
Professional Counselor
Primary
8454-125
WI
Other
Enumeration date
08/19/2019
Last updated
03/08/2022
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