Individual
REBECCA MIXTACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7011
Mailing address
2500 OVERLOOK TER, MADISON, WI 53705-2254
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134816-121
WI
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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