Organization
CHAMELEON GROUP
Active
Other names
Wisconsin Early Autism Project
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LAUREE SCHUTT-CHARDON (DIRECTOR OF BILLING)
(608) 662-9327
Entity
Organization
Contact information
Practice address
1210 FOURIER DRIVE, SUITE #100, MADISON, WI 53717-1969
(608) 662-9327
(608) 662-9041
Mailing address
1210 FOURIER DRIVE, SUITE #100, MADISON, WI 53717-1969
(608) 662-9327
(608) 662-9041
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
HFS 61.91
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42223400
—
WI
Enumeration date
09/25/2007
Last updated
11/17/2015
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