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Individual

LACY JANE RUDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, SAC

Contact information

Practice address
710 JOHN NOLEN DR, MADISON, WI 53713-1422
(608) 280-2700
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15963-131
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YA0400X
WI
Enumeration date
03/20/2015
Last updated
08/30/2016
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