Individual
KATHRYN LYNN MAZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 RAY O VAC DR STE 220, MADISON, WI 53711-2476
(608) 276-9191
(608) 276-9144
Mailing address
524 TROY DR, MADISON, WI 53704-1575
(608) 445-3339
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5923-125
WI
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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