Individual
MRS. JAN LOUISE BASOM SCHUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
(608) 283-7193
Mailing address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
(608) 283-7193
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3285-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043404692
—
WI
Enumeration date
08/28/2007
Last updated
02/01/2018
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