Individual
PATRICK MOMOH FAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
802 E GORHAM ST, MADISON, WI 53703-1524
(608) 280-4700
(608) 280-4730
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
171M00000X
WI
Other
Enumeration date
10/23/2020
Last updated
11/27/2023
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