Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6223-125 | WI |
N | 101YP2500X | Professional Counselor | CC01275 | MN |
NPI | 1003262080 |
---|---|
Provider Name | Sherrie L Walter |
First Address | Onalaska, WI 54650-8556 |
Second Address | Onalaska, WI 54650-8556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2016 |
Last Update Date | 03/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100056202 | (05) | WI |