person
Makena Lizabeth Detlor, LPC-IT
Mental Health Counselor in Wisconsin Rapids, Wisconsin
NPI 1336845817

Makena Lizabeth Detlor is a Mental Health Counselor based in Wisconsin Rapids, WI and is specialized in Mental Health. Makena Lizabeth Detlor practices in Wisconsin Rapids, WI and has the professional credentials of LPC-IT. The NPI Number for Makena Lizabeth Detlor is 1336845817 and holds a License No. 7240-226 (Wisconsin).

The current practice location address for Makena Lizabeth Detlor is 320 W Grand Ave Ste 304A, Wisconsin Rapids, WI and can be reached out via phone at 715-424-6960.

Location: 320 W Grand Ave Ste 304A, Wisconsin Rapids, WI, 54494-5934
person
Provider Profile Details
NPI Number
1336845817
Provider Name
Makena Lizabeth Detlor
Credential
LPC-IT
Provider Entity Type
Individual
Gender
Female
Address
320 W Grand Ave Ste 304A, Wisconsin Rapids, WI, 54494-5934
Phone Number
715-424-6960
Fax Number
Provider Enumeration Date
02/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
320 W Grand Ave Ste 304A
City
State
Zip
54495-2781
Phone Number
715-424-6960
Fax Number
person
Provider Business Mailing Address Details
Address
320 W Grand Ave Ste 304A
City
State
Zip
54495-2781
Phone Number
715-424-6960
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
7240-226 (Wisconsin)
Definition
Definition to come...
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