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Individual

BEVERLY HILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
900 JOHN NOLEN DR, SUITE 100, MADISON, WI 53713-1465
(608) 256-5030
(608) 256-5038
Mailing address
900 JOHN NOLEN DR, SUITE 100, MADISON, WI 53713-1465
(608) 256-5030
(608) 256-5038

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3166-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39755400
WI
Enumeration date
05/31/2007
Last updated
07/08/2007
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