Individual
HEATHER H DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CTRS,LPC
Contact information
Practice address
6502 GRAND TETON PLZ, SUITE 203, MADISON, WI 53719-1047
(608) 827-7220
Mailing address
4410 MINERAL POINT RD, MADISON, WI 53705-5045
(608) 358-4977
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
475-226
WI
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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