Individual
MRS. JENNA L WALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
2914 INDUSTRIAL DR, MADISON, WI 53713-4047
(608) 223-3311
Mailing address
314 N PLEASANT ST, CAMBRIDGE, WI 53523-9404
(608) 843-7966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19298-130
WV
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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