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General NPI Number Information
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NPI Number | 1770105306
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Entity Type | Individual
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Provider Name | CARRIE IMOEHL LPC
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Gender | Female
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 4848 S 76TH ST
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City | GREENFIELD
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State | WI
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Zip | 53220-4361
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Country | US
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Telephone | 262-510-2838
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Fax |
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Provider Business Mailing Address
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Address Line | 3813 S BROOK PL
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City | ST FRANCIS
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State | WI
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Zip | 53235-4205
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Country | US
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Telephone | 262-510-5381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8442-125
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License Number State | WI
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