Organization
MIND EVOLUTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHELE KLASSY LCSW (OWNER)
(608) 206-3767
Entity
Organization
Contact information
Practice address
401 WISCONSIN AVE, MADISON, WI 53703-1487
(608) 256-5115
Mailing address
1078 HWY 69, BELLEVILLE, WI 53508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
06/06/2019
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