Individual
AMY WEIDERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
122 W WASHINGTON AVE STE 630, MADISON, WI 53703-2758
(608) 236-4460
Mailing address
962 LAWRENCE ST, MADISON, WI 53715-2039
(608) 395-9243
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4494
WI
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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