Individual
MS. PETROVNIA FERNANDE MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6502 GRAND TETON PLZ, SUITE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Mailing address
6502 GRAND TETON PLZ, SUITE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8317-123
WI
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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