Individual
THERESA ANN MLECZKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5686
(608) 363-5756
Mailing address
514 PRAIRIE ST, ROCKFORD, IL 61107-4036
(815) 962-9682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3888-125
WI
101YM0800X
Mental Health Counselor
—
IA
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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