institution
Kathleen Bullard Psychotherapy Llc
Professional Counselor in Lake Geneva, Wisconsin
NPI 1063993038

Kathleen Bullard Psychotherapy Llc is a Professional Counselor based in Lake Geneva, WI and is specialized in Professional. Kathleen Bullard Psychotherapy Llc practices in Lake Geneva, WI. The NPI Number for Kathleen Bullard Psychotherapy Llc is 1063993038 and holds a License No. 16105-131 (Wisconsin).

The current practice location address for Kathleen Bullard Psychotherapy Llc is 647 W Main St, Lake Geneva, WI and can be reached out via phone at 262-806-1467.

Location: 647 W Main St, Lake Geneva, WI, 53147-1990
institution
Provider Profile Details
NPI Number
1063993038
Provider Name
Kathleen Bullard Psychotherapy Llc
Credential
Provider Entity Type
Organization
Address
647 W Main St, Lake Geneva, WI, 53147-1990
Phone Number
262-806-1467
Fax Number
Provider Enumeration Date
08/27/2018
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1033550934 05 WI
institution
Provider Business Practice Location Address Details
Address
647 W Main St
City
State
Zip
53147-1990
Phone Number
262-806-1467
Fax Number
person
Provider Business Mailing Address Details
Address
647 W Main St
City
State
Zip
53147-1990
Phone Number
262-806-1467
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
6363-125 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
16105-131 (Wisconsin)
Definition
Definition to come...
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