Organization
EATING DISORDER SUPPORT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA J WALDEN MS, LPC (OWNER)
(608) 843-7055
Entity
Organization
Contact information
Practice address
429 GAMMON PL STE 200, MADISON, WI 53719-1053
(608) 843-7055
(608) 821-0938
Mailing address
429 GAMMON PL STE 200, MADISON, WI 53719-1053
(608) 843-7055
(608) 821-0938
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
WI
Enumeration date
07/12/2021
Last updated
07/12/2021
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