Individual
BETH GULLICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5534 MEDICAL CIR, MADISON, WI 53719-1202
(608) 274-0355
(608) 274-5546
Mailing address
5534 MEDICAL CIR, MADISON, WI 53719-1202
(608) 274-0355
(608) 274-5546
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
749-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43722600
—
WI
Enumeration date
02/20/2008
Last updated
02/20/2008
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