Individual
KATHLEEN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOM
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1766
Mailing address
1265 JOHN Q HAMMONS DR, MADISON, WI 53717-1941
(608) 257-3842
(608) 257-3842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
324
WI
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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