| Doctor Name: | MRS. KARLA F WILLIS |
| NPI Number: | 1083912067 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPC |
| License Number: | 4141-125 |
| Business Practice Address: | 108 N Lincoln Ave Beaver Dam, WI - 539162110 |
| Business Phone Number: | 9208878751 |
| Business Fax Number: | 9208873977 |
| Mailing Address: | 108 N Lincoln Ave, BEAVER DAM |
| State: | WI |
| Postal Code: | 539162110 |
| Phone Number: | 9208878751 |
| Fax Number: | 9208873977 |
| NPI Enumeration Date: | 03/01/2011 |
| NPI Last Update Date: | 03/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4141-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |