Individual
MIRIAM ELIE PORAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT, MFT
Contact information
Practice address
49 KESSEL CT, MADISON, WI 53711-6200
(608) 280-2700
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4359-226
WI
106H00000X
Marriage & Family Therapist
Primary
705-228
WI
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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