Individual
PAPA FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
330 W LAKESIDE ST STE B, MADISON, WI 53715-2072
(414) 801-9208
Mailing address
330 W LAKESIDE ST STE B, MADISON, WI 53715-2072
(414) 801-9208
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8784
WI
Other
Enumeration date
10/01/2020
Last updated
07/21/2026
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