Individual
STACIE SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 FOURIER DR STE 100, MADISON, WI 53717-1969
(608) 662-9327
Mailing address
1210 FOURIER DR STE 100, MADISON, WI 53717-1969
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/15/2021
Last updated
03/15/2021
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