Individual
MISS KATHERINE ANN PREMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
6502 GRAND TETON PLZ STE 204, MADISON, WI 53719-1047
(608) 338-1786
Mailing address
309 W WASHINGTON AVE UNIT 212, MADISON, WI 53703-3590
(715) 379-6149
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1149-124
WI
Other
Enumeration date
10/10/2016
Last updated
06/06/2019
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