Individual
AMANDA KOSHOLLEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
1717 N STOUGHTON RD, MADISON, WI 53704-2605
(608) 838-8999
Mailing address
1717 N STOUGHTON RD, MADISON, WI 53704-2605
(608) 838-8999
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8401-226
WI
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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