Individual provider · Type 1 NPI
Theresa Dewalt
Professional Counselor · Racine, WI
NPI number
1699933036
Active
Practice location
1220 Mound Ave Ste 304
Racine, WI 53404-3350
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 3369-125 (WI) |
Professional Counselor: Definition to come...
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About NPI 1699933036
Theresa Dewalt's National Provider Identifier is 1699933036, issued on May 31, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Racine, WI. The record was last updated on May 31, 2008.