Individual
MARY HEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
4109 67TH ST, KENOSHA, WI 53142-3836
(262) 652-9830
(262) 652-2931
Mailing address
4109 67TH ST, KENOSHA, WI 53142-3836
(262) 652-9830
(262) 652-2931
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
357-226
WI
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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