Organization
FAMILYPATH AUTISM SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE THOMAS (MEMBER)
(608) 513-2272
Entity
Organization
Contact information
Practice address
575 DONOFRIO DR STE 101, MADISON, WI 53719-2832
(608) 512-0780
(608) 841-1059
Mailing address
575 DONOFRIO DR STE 101, MADISON, WI 53719-2832
(608) 512-0780
(608) 841-1059
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
222957
WI
106H00000X
Marriage & Family Therapist
Primary
674124
WI
Other
Enumeration date
10/31/2014
Last updated
05/05/2015
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