Organization
LAVENDER & IVY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA ROSE DIETZ APSW (OWNER/CLINICAL PSYCHOTHERAPIST)
(651) 302-3496
Entity
Organization
Contact information
Practice address
121 E MAIN ST FL 3, MADISON, WI 53703-3351
(608) 389-0148
Mailing address
1630 FORDEM AVE APT 304, MADISON, WI 53704-7137
(651) 302-3496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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