Individual
KENDALL CHRISTINE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
151 E BADGER RD, MADISON, WI 53713-2708
(608) 250-2512
Mailing address
151 E BADGER RD, MADISON, WI 53713-2708
(608) 250-2512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18652-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18652-130
—
WI
Enumeration date
09/12/2018
Last updated
09/12/2018
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