Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 5172-226 | WI |
NPI | 1003574252 |
---|---|
Provider Name | Tanya L Kessen |
First Address | Onalaska, WI 54650-2814 |
Second Address | Tomah, WI 54660-1199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2021 |
Last Update Date | 06/12/2021 |