Individual
MARY WIMSATT FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1017 W GLEN OAKS LN STE 166, MEQUON, WI 53092-3371
(262) 622-6353
Mailing address
1017 W GLEN OAKS LN STE 166, MEQUON, WI 53092-3371
(262) 622-6353
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
3513-57
WI
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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