Individual
MS. MARY KAY AIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
5005 UNIVERSITY AVE, MADISON, WI 53705-5439
(608) 239-1066
Mailing address
110 MERRILL CREST DR, MADISON, WI 53705-2706
(608) 239-1066
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
585-125
WI
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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