Organization
IN THE MOMENT CHILD AND FAMILY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN MOFFETT HARWOOD MS (SOLE PROPRIATOR)
(608) 436-0506
Entity
Organization
Contact information
Practice address
6705 WESNER RD, VERONA, WI 53593-9178
(608) 620-3486
Mailing address
653 GARFIELD AVE, EVANSVILLE, WI 53536-1067
(608) 436-0506
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
2694-226
WI
251S00000X
Community/Behavioral Health Agency
Primary
478-228
WI
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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