Organization
212 PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA KC HISER LPC (OWNER)
(608) 516-4347
Entity
Organization
Contact information
Practice address
7109 BRINDLEY CIR, MADISON, WI 53719-2128
(608) 205-8650
Mailing address
7109 BRINDLEY CIR, MADISON, WI 53719-2128
(608) 516-4347
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098189
—
WI
05
—
43741200
—
WI
Enumeration date
01/22/2020
Last updated
05/09/2024
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